Atelectasis Clinical Presentation

Updated: Dec 06, 2018
  • Author: Tarun Madappa, MD, MPH; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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Presentation

History

Atelectasis may occur postoperatively following thoracic or upper abdominal procedures.

Although atelectasis is considered to be the most common cause of early postoperative fever, the existing evidence is contradictory. In a study by Mavros et al, they found no clinical evidence supporting the concept that atelectasis is associated with early postoperative fever. [5]

Most symptoms and signs are determined by the rapidity with which the bronchial occlusion occurs, the size of the lung area affected, and the presence or absence of complicating infection.

Rapid bronchial occlusion with a large area of lung collapse causes pain on the affected side, sudden onset of dyspnea, and cyanosis. Hypotension, tachycardia, fever, and shock may also occur.

Slowly developing atelectasis may be asymptomatic or may cause only minor symptoms. Middle lobe syndrome often is asymptomatic, although irritation in the right middle and right lower lobe bronchi may cause a severe, hacking, nonproductive cough.

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Physical Examination

The physical examination findings may demonstrate dullness to percussion over the involved area and diminished or absent breath sounds. Chest excursion of the involved hemithorax may be reduced or absent. The trachea and the heart may be deviated toward the affected side.

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Complications

Complications may include the following:

  • Acute pneumonia

  • Hypoxemia and respiratory failure

  • Postobstructive drowning of the lung

  • Sepsis

  • Pleural effusion and empyema

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