Atelectasis: Description
In atelectasis, parts of the lungs or the entire lung are deflated. The term comes from the Greek and translates as “incomplete expansion”.
In atelectasis, air can no longer enter the alveoli. There are many possible reasons for this. For example, the alveoli may have collapsed or become blocked, or they may be compressed from the outside. In any case, the area in question is no longer available for gas exchange. Atelectasis is therefore a serious condition.
Forms of atelectasis
Doctors generally distinguish between two forms of atelectasis:
- Secondary or acquired atelectasis: it occurs as a result of another disease.
Atelectasis: Symptoms
Atelectasis limits lung function. The symptoms it causes depend, among other things, on how large the affected lung segment is and whether atelectasis developed suddenly or gradually. The cause of the collapsed lung also shapes the symptoms.
Acquired atelectasis: symptoms
If atelectasis occurs quite suddenly, for example because the airways are blocked, those affected complain of severe shortness of breath (dyspnea), and in some cases also of stabbing pain in the chest. If large areas of the lungs have collapsed, circulatory shock can also occur. In this case, blood pressure suddenly drops sharply and the heart beats rapidly (tachycardia).
Congenital atelectasis: symptoms
Symptoms of congenital atelectasis, as seen in premature infants, often appear immediately after birth or within the first few hours of life. In affected premature infants, the skin turns bluish. They breathe rapidly. The areas between the ribs and above the breastbone are drawn in when they breathe in, and the nostrils move more. Affected infants often moan when they exhale as an expression of their shortness of breath.
Congenital and acquired atelectasis can have many different causes.
Congenital atelectasis: Causes
The following are possible causes of congenital atelectasis:
- obstructed airways: If the newborn breathes in mucus or amniotic fluid, the lungs cannot fill properly with air. Atelectasis can also result from malformations that obstruct airflow in the airways.
- Respiratory center dysfunction: If the respiratory center in the brain is damaged (for example, by a brain hemorrhage), the reflex to take a breath may be absent after birth.
Acquired atelectasis: Causes
Causes of acquired atelectasis include:
- Obstructive atelectasis: where the airways are obstructed, for example, by a tumor, viscous mucus, or a foreign body.
- Compression atelectasis: The lungs are compressed externally, for example by an effusion of fluid in the chest cavity or a very enlarged lymph node.
Atelectasis: examinations and diagnosis
In most cases, typical symptoms point to atelectasis – in many cases, the underlying disease also suggests that there is a functional disorder of the lungs.
Congenital atelectasis
An X-ray examination confirms the diagnosis and also indicates the degree of immaturity of the lungs.
The diagnosis of congenital atelectasis is usually made by a pediatrician who specializes in treating premature infants (neonatologist).
Acquired atelectasis
This is followed by a physical examination: the doctor listens to the affected person’s lungs with a stethoscope. In the case of atelectasis, the normal breathing sounds are attenuated.
In addition, the doctor taps the chest with his fingers – the tapping sound is altered in the area of atelectasis.
Atelectasis: Treatment
The treatment of atelectasis depends primarily on its cause. The primary goal is to restore lung function as soon as possible and to supply the body with sufficient oxygen.
If, for example, a foreign body or mucus plug in the airways is the reason for the collapsed lung area, this must be removed or suctioned out accordingly.
If a lung tumor is responsible for atelectasis, it is usually removed surgically.
In the case of a pneumothorax, the air that has entered between the lung and the chest wall is often sucked out via a thin tube (pleural drainage). In mild cases, however, treatment is not always necessary – one waits for spontaneous healing (under clinical observation of the patient).
Atelectasis: course of the disease and prognosis
Atelectasis is not a disease in its own right, but a concomitant condition that can have many different causes. Therefore, a general statement about the course or prognosis is not possible. Rather, the underlying disease determines the course of the disease. If this can be treated well, the function of the lungs can usually be restored.
Atelectasis: Prevention
Acquired atelectasis cannot be prevented by any particular measure.