Right Atelectasis

by Kevin Pederson


Atelectasis refers to a condition where a part of or the entire lung collapses. Derived from the Greek words 'ateles' and 'ektasis,' atelectasis means incomplete expansion, in this case - an incomplete expansion of the lungs. There are several types of atelectasis, each with its own causes and symptoms. One such type of atelectasis is known as right atelectasis. The lungs consist of a right lung and a left lung. The right lung has three lobes - the upper, middle, and lower whereas the left lung has only two lobes - the left upper and the lower lobe. Lobes are divided by fissures. The upper and middle right lobes are separated from the lower by the right major fissure. When atelectasis or a decrease in lung volume occurs in one or more of the right lobes, it is referred to as a right lung atelectasis.

Atelectasis is not a disease on its own but rather a condition that arise as a result or complication of another ailment or abnormality in the body. Atelectasis is most common after surgery or as a side effect of long-term hospitalization or confinement to the bed. Although these are usually cases of left lobe atelectasis as the heart in supine position presses down and compresses the bronchus of the left lung. In some cases, atelectasis can also accompany other forms of lung disease such as cystic fibrosis, COPD, pneumonia and severe asthma. The most common cause of right lung or right basal atelectasis is pneumothorax or the leakage of air into the space around the lungs. Other possible causes of atelectasis include:

  • Lung tumors
  • Mucus plug
  • Complication of anesthesia
  • Chest injury
  • Cardiac enlargement
  • Fracture of the ribs
  • Scoliosis
  • Polio
  • Obstruction of the bronchioles
  • Foreign body in the airways
  • Lung cancer
  • Pulmonary edema
  • Toxic inhalation

Risk factors that increase a person's chance of developing atelectasis include:

  • Obesity
  • Smoking
  • Old age
  • Muscular dystrophy
  • Pregnancy
  • Heart or abdominal surgery
  • Other lung disorders
  • Premature birth and lung immaturity

Irrespective of the type, common symptoms of atelectasis include:

  • Chest pain
  • Rapid or shallow breathing
  • Wheezing
  • Chronic cough (with or without blood)
  • Fever

As the disease worsens, symptoms of right basilar atelectasis may include:

  • Confusion
  • Coughing brown mucus or blood
  • Sleepiness and fatigue
  • High fever
  • Worsening breathing difficulties and chest pain

Patients who have undergone recent surgery (especially heart bypass surgery) are usually checked for atelectasis during their hospital stay. A chest x-ray will indicate abnormalities in the lungs immediately and determine the extent of the collapse. Other tests that are used to diagnose atelectasis include CBC or blood count, kidney profile tests, serum electrolyte tests, pulse oximetry, CT scan of the chest, MRI scan of the chest and pulmonary function tests.

Depending on the cause of the condition and the severity of the symptoms, treatment can range from chest wall percussion, postural drainage, and a forced expiration technique known as huffing. Medications such as bronchodilators may also help provide relief from breathing difficulties. In cases of post-operative atelectasis, prevention is preferred to treatment. If you are obese, lose weight and if you smoke, stop immediately. Gentle exercise and movement after surgery is encouraged and regular changes of position if confined to the bed is necessary. Deep breathing exercises to strengthen the lungs are also recommended to patients undergoing any major surgery and under the use of general anesthesia. In severe cases, supplemental oxygen and intravenous antibiotics may be prescribed.

References:

http://www.med.nyu.edu/content?ChunkIID=12032


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