Atelectasis Differential Diagnoses

Updated: Oct 22, 2020
  • Author: Tarun Madappa, MD, MPH; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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Diagnostic Considerations

Bronchogenic carcinoma, which may present with atelectasis, must be excluded in all patients older than 35 years.

A pneumothorax can produce patient complaints similar to atelectasis. However, on physical examination, the percussion note is hyper-resonant and the heart and mediastinum are pushed to the opposite side. Chest radiographs are diagnostic.

A massive pleural effusion may cause dyspnea, cyanosis, and weakness. On physical examination, there is typically dullness to precussion and absent breath sounds of the involved hemithorax. The heart and mediastinum may be deviated away from the involved area.

The following may be areas of medicolegal concern regarding diagnosis:

  • Failure to consider lobar or segmental collapse when a loss of volume is observed on chest radiographs

  • Failure to exclude an endobronchial abnormality when evaluating a patient with lobar collapse

  • Failure to recognize that the lung collapse is a medical emergency because patients may develop respiratory distress and hypoxemia

  • Failure to consider bronchoscopy as a diagnostic and therapeutic procedure for patients with lung collapse

Differential Diagnoses