Atelectasis (Lung Collapse): Causes, Symptoms, and Treatment

Atelectasis is partial or complete collapse of a lung or lobe due to alveolar deflation. It is a common postoperative complication and occurs in many respiratory conditions.

Mechanisms

• Obstructive: Airway blockage (mucus plug, tumor, foreign body) → air absorption distal to obstruction.
• Compressive: External pressure (pleural effusion, pneumothorax, tumor, abdominal distension).
• Adhesive: Surfactant deficiency (ARDS, prematurity) → alveolar instability.
• Cicatrization: Fibrosis from TB, radiation, infection.
• Relaxation (passive): Loss of contact between parietal/visceral pleura (pneumothorax, effusion).

Symptoms

• Dyspnea (degree depends on extent/rate)
• Cough, possibly productive
• Chest pain (pleuritic if adjacent pleura inflamed)
• Fever (if infectious cause or secondary pneumonia)
• Tachycardia, hypoxemia

Diagnosis

• Chest X-ray: volume loss, displacement of fissures, elevated diaphragm, crowding of vessels.
• CT: defines cause (obstruction, mass).
• Bronchoscopy: visualizes airway, allows therapeutic clearance.

Treatment

• Obstructive: Bronchoscopy for mucus plug/FB removal; tumor debulking/stenting.
• Compressive: Drain effusion/air; treat underlying cause.
• Postoperative prevention: Incentive spirometry, early mobilization, adequate analgesia, CPAP.
• Medications: Bronchodilators, mucolytics, surfactant (neonates).

Most atelectasis is reversible with prompt intervention. Persistent collapse risks infection and bronchiectasis.