Compressive atelectasis is a medical condition where a patient's lung cannot fully inflate, limiting the volume of air the patient can inhale with a given breath. This condition can have a number of causes, and it requires medical treatment to address the dysfunction in the lung and help the patient breathe. Patients with untreated compressive atelectasis can be at risk of complications associated with low oxygenation, like organ damage. The condition may also be associated with another medical issue that requires treatment even if the patient doesn't experience problems because of the decreased lung function.
In patients with compressive atelectasis, air is forced out of the alveoli, the little sacs inside the lungs that facilitate gas exchange. Contact between the inner and outer pleura is lost as the lung deflates. This contact is critical for management of surface tension to allow the lung to inflate after the patient exhales. When the pleura are not in contact, the patient will struggle to fill the lung, because the surface tension rises. The lung may remain flat, or may partially inflate.
One potential cause of compressive atelectasis is distension in the abdomen. This may occur in certain illnesses; as a result of surgical complications; or in the wake of a severe injury. The distended abdomen can push against the lung, forcing the alveoli to deflate and breaking the surface tension that keeps the lung functional. Patients may also experience this condition if a mass is present in the chest and becomes large enough to press against the lung. This can be observed in some lung cancer patients.
A patient with compressive atelectasis may experience symptoms like wheezing, gasping, chest pain, and difficulty breathing. In a medical examination a doctor may be able to detect decreased breath sounds on the involved side. Medical imaging can provide more information about what is going on inside the chest, although sometimes the case may be apparent; the patient could have a grossly distended abdomen because of an infection, for example.
Treatment options can include addressing the cause, providing the patient with medications and physiotherapy, and respiratory support, if necessary. Some patients may need a bronchoscopy examination of the lungs, which may provide an opportunity to examine or remove a mass. In some cases, surgery is required to treat the issue and restore the patient's normal lung function. The patient may also need therapy after treatment to redevelop strength and monitor lung function in case it does not return to previous levels.