Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology department,shoahada tajrish hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : mirhadi razavian

Case Section

Chest Imaging

Patient's Information

Gender : Male
Age : 35

Clinical Summary

A 35 y/o male with dyspnea

Imaging Findings

Chest x-RAY demonstrates reticulonodular infilteration in LLL ,deviation of heart and mediastinum to left sided of chest,decrease volume of left sided lung ,increase volume of right sided lung and mild elevation of left hemidiaphragm. CT demonstates left sided deviation of heart and mediastinam ,total collapse and consolidation of LLL ,air fluid level in trachea both main bronchous especially in left main bronchous that followed by complete obstruction of LLL branches and moderate to severe obstruction of left upper lobe and lingular branches.

Differential Diagnosis

.......................

Final Diagnosis

Atelectasis of LLL by moucus plug

Discussion (Related Text)

Atelectasis may be the result of a blocked airway (obstructive) or of pressure from outside the lung (nonobstructive).
. There may be no obvious signs or symptoms of atelectasis. If you do experience signs and symptoms, they may include:
• Difficulty breathing (dyspnea)
• Rapid, shallow breathing
• Coughing
• Low-grade fever
A blockage in your air passages (bronchial tubes) can cause obstructive atelectasis. Possible causes of blockage include:
• Mucus plug. Accumulation of mucus in your airways, often occurring during and after surgery because you can't cough, is the most common cause of atelectasis. Drugs given during surgery make the lungs inflate less fully than usual, so normal secretions collect in the airways. Suctioning the lungs during surgery helps clear away these secretions, but they may continue to build up afterward. This is why it's important to breathe and cough deeply during your recovery. Expanding the lungs gets air around the mucus plugs and makes them easier to cough out. Mucus plugs also are common in people with cystic fibrosis and during severe asthma attacks.
• Foreign body. Children are most likely to inhale an object, such as a peanut or small toy part, into their lungs.
• Narrowing of major airways from disease. Chronic infections, including fungal infections, tuberculosis and other diseases can scar and constrict major airways.
• Tumor in a major airway. An abnormal growth can narrow the airway.
• Blood clot. This occurs only if there's significant bleeding into the lungs that can't be coughed out.
Possible causes of nonobstructive atelectasis include:
• Injury. Chest trauma — from a fall or car accident, for example — can cause you to avoid taking deep breaths (due to the pain), which can result in compression of your lungs.
• Pleural effusion. This is a buildup of fluid between the tissues (pleura) that line the lungs and the inside of the chest wall.
• Pneumonia. Different types of pneumonia, an inflammation of your lungs, temporarily can cause atelectasis. An atelectatic lung that remains collapsed for a few weeks or more can result in bronchiectasis (brong-key-EK-tuh-sis), a condition in which damage to the airways causes them to widen and become flabby and scarred.
• Pneumothorax. Air leaks into the space between your lungs and chest wall, indirectly causing some or all of a lung to collapse.
• Scarring of lung tissue. Scarring could be caused by injury, lung disease or surgery. In these rare cases, the atelectasis is minor compared with the damage to the lung tissue from the scarring.
• Tumor. A large tumor can press against and deflate the lung, as opposed to blocking the air passages.
A chest X-ray usually can diagnose atelectasis. Symptoms of a respiratory infection, especially pneumonia, on a child's chest X-ray may indicate a foreign body, the most common cause of obstructive atelectasis in children.
To determine the underlying cause, your doctor may order other tests, including

References

• Newsletter: Mayo Clinic Health Letter
• Book: Mayo Clinic Family Health Book, 4th Edition

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