Rounded Atelectasis

by Shaun Damon

If one or more areas of the lungs do not inflate properly, atelectasis occurs. During breathing, air passes through the nose and mouth and into the windpipe. Then, it travels into alveoli, air sacs. In the air sacs, exchange of gas takes place. The exchange of gas works well only if the air sac remains open. Surfactants, a coating inside the lungs, help the air sacs remain open. In atelectasis condition, the air sacs are no longer filled with air due to the collapsed lung. Consequently, exchanges of gas does not occur.

Rounded Atelectasis


Round atelectasis is an unusual type of atelectasis. It is also known as folded lung or Blesovsky syndrome as there is an infolding of redundant pleura occurs. It is most commonly associated with asbestos lung exposure. Congestive heart failure, TB, and pulmonary infraction are also some of the causes of rounded atelectasis. Atelectasis is also common after surgery. After surgery, medications make the patient sleep. This can decrease the normal effort of breathing, resulting in the lung collapse.

The collapse of alveoli in the lung interrupts the breathing in the area. If small areas of lung are affected, there will be no symptoms as the rest of the lung can bring in oxygen to make up the collapsed part. If it affects a large area, it will result in complications as body organs might not get enough oxygen rich blood.

Common symptoms include fever and cough. Rapid breathing, wheezing, difficulty breathing, and coughing up blood are symptoms in severe cases. Deep breathing exercise, oxygen therapy, medication help to treat atelectasis.

Atelectasis Infiltrate


The substances that fill the air sacs are called infiltrates. Lung disorders such as pneumonia, asbestosis, and cystic fibrosis causes filling of air spaces with fluids comprised of white blood cells, pus, cancer cells, proteins, immunological substances, blood, etc. When the infiltrates in lungs involve a small area of the lung, it can result in minor symptoms. If infiltrates in lungs completely fill the entire area of the lung, it becomes a life-threatening condition.

Basilar atelectasis infiltrate is a respiratory disorder. The collapse of the air sacs located at the base of the lungs is called basilar atelectasis infiltrate. It occurs due to the inability of the lung to expand during breathing. It is common after surgery due to inactivity. Obstruction of the airway can also cause basilar atelectasis. It is mild condition and can be treated easily by using breathing machines to increase air take and re-expand the air sacs back to normal.

If both left and right bottom parts of the lung are squeezed into a smaller than normal size, it is known as bibasilar atelectasis infiltrate. Obesity, taking small breaths, medications that suppress cough, and plugs of mucus are some of the causes of bibasilar atelectasis infiltrate. In severe cases, blood clots can present with bibasilar atelectasis.

Anesthesia, lung diseases, shallow breathing, prolonged bed rest, and obstructions such as tumors, mucus, and foreign object in the airways are some of the common causes of atelectasis.

Warning signs of atelectasis include:

  • Coughing blood
  • Coughing mucus
  • Excessive sleepiness
  • Worsening wheezing
  • Worsening coughing
  • High fever
  • Shortness of breath
Treatment for atelectasis involves re-expanding the collapse lung tissues. Compressive atelectasis that develops due to the pressure of fluid on the lung can be treated by removing the fluid that can allow the lung to expand. Mucus plugs in the airway can be loosened using percussion on the chest. Performing deep breathing exercises using incentive spirometry devices helps to fill the air sacs. Postural drainage, tilting the person, allows the mucus to drain easily. Inhaled medications help to open the airway. Treating tumors and removing blockages by procedures like bronchoscopy allows the lungs to expand.

Atelectasis can be prevented by taking certain measures. Avoiding narcotic pain medications, alcohol, smoking, and exposure of secondary smoking. Performing deep breathing exercises after surgery helps to avoid atelectasis after surgery.

References:
  1. http://www.nhlbi.nih.gov/health/health-topics/topics/atl/printall-index.html
  2. http://www.ncbi.nlm.nih.gov/pubmed/15823460

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