eMedicine Specialties > Pediatrics: General Medicine > Pulmonology

Atelectasis, Pulmonary: Differential Diagnoses & Workup

Author: Michael R Bye, MD, Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center
Contributor Information and Disclosures

Updated: Sep 8, 2009

Differential Diagnoses

Pneumonia

Workup

Laboratory Studies

  • Laboratory studies in pulmonary atelectasis should include measurement of oxygenation, either by oximetry or ABG.
  • Pulmonary function studies may detect unrecognized airflow obstruction, restrictive disease, or decreased respiratory muscle pressures.

Imaging Studies

  • CT scanning
    • ChestCT scanning may help evaluate for compression of the airway.
    • CT scanning may also detect any underlying pathology that predisposes to atelectasis. It may also reveal diffuse disease not suggested by plain radiography.
  • Chest radiography: Plain chest radiography is often the first study to reveal atelectasis.

Procedures

  • Flexible or rigid bronchoscopy may help distinguish intrinsic obstruction from extrinsic compression. These tests can also better define the nature of any intrinsic obstructing lesion.
  • Bronchoscopy offers the advantage of potential treatment. This can include removal of secretions with a rigid or flexible bronchoscope or removal of a foreign body, generally with a rigid bronchoscope.

More on Atelectasis, Pulmonary

Overview: Atelectasis, Pulmonary
Differential Diagnoses & Workup: Atelectasis, Pulmonary
Treatment & Medication: Atelectasis, Pulmonary
Follow-up: Atelectasis, Pulmonary
Multimedia: Atelectasis, Pulmonary
References

References

  1. Engoren M. Lack of association between atelectasis and fever. Chest. Jan 1995;107(1):81-4. [Medline].

  2. Bilan N, Galehgolab BA, Shoaran M. Medical treatment of lung collapse in children. Pak J Biol Sci. Mar 1 2009;12(5):467-9. [Medline].

  3. [Guideline] National Heart, Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma (EPR-3). [Full Text].

  4. Bagley CE, Gray PH, Tudehope DI, Flenady V, Shearman AD, Lamont A. Routine neonatal postextubation chest physiotherapy: a randomized controlled trial. Journal of Paedtrics & Child Health. November 2005;41:592-7. [Medline].

  5. De Boeck K, Willems T, Van Gysel D. Outcome after right middle lobe syndrome. Chest. Jul 1995;108(1):150-2. [Medline].

  6. Finder J, Birnkrant DJ, Carl J et al. Respiratory care of the patient with Duchenne muscular dystrophy: An official ATS consensus statement. Am J Respir Crit Care Med. 2004;170:456.

  7. Hendriks T, de Hoog M, Lequin MH, Devos AS, Merkus PJ. DNAse and atelectasis in non-cystic fibrosis pediatric patients. Critical Care. August 2005;9:351-6. [Medline].

  8. Miske LJ, Hickey EM, Kolb SM, et al. Use of the mechanical in-exsufflator in pediatric patients with neuromuscular disease and impaired cough. Chest. Apr 2004;125(4):1406-12. [Medline].

  9. Schindler MB. Treatment of atelectasis: where is the evidence?. Crit Care. Aug 2005;9(4):341-2. [Medline].

  10. Slattery DM, Waltz DA, Denham B, et al. Bronchoscopically administered recombinant human DNase for lobar atelectasis in cystic fibrosis. Pediatr Pulmonol. May 2001;31(5):383-8. [Medline].

  11. Stiller K. Physiotherapy in intensive care: towards an evidence-based practice. Chest. Dec 2000;118(6):1801-13. [Medline].

  12. Woodring JH. Determining the cause of pulmonary atelectasis: a comparison of plain radiography and CT. AJR Am J Roentgenol. Apr 1988;150(4):757-63. [Medline].

  13. Wu KH, Lin CF, Huang CJ, Chen CC. Rigid ventilation bronchoscopy under general anesthesia for treatment of pediatric pulmonary atelectasis caused by pneumonia: A review of 33 cases. Int Surg. Sep-Oct 2006;91(5):291-4. [Medline].

Further Reading

Keywords

lung, pulmonary collapse, collapsed lung, asthma, cystic fibrosis, CF, hypoxemia, extrinsic airway obstruction, intrinsic airway obstruction, bronchiolitis, aspiration from swallowing disorder, endobronchial tuberculosis, aspiration from gastroesophageal reflux, airway foreign bodies, increased airway secretions, enlarged lymph nodes, compressed lung tissue, pulmonary atelectasis, transient hypoxemia, lymphoma, hypoventilation, tachypnea, treatment, diagnosis

Contributor Information and Disclosures

Author

Michael R Bye, MD, Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center
Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society
Disclosure: Merck Honoraria Speaking and teaching

Medical Editor

Thomas Scanlin, MD, Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School
Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Charles Callahan, DO, Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center
Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

CME Editor

Mary E Cataletto, MD, Associate Director, Division of Pediatric Pulmonology, Winthrop University Hospital; Professor of Clinical Pediatrics, State University of New York at Stony Brook; Director of Children's Sleep Services, Winthrop University Hospital
Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians
Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD, Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center
Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society
Disclosure: Merck Honoraria Speaking and teaching

 
 
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