II. Pathophysiology

  1. Lung consolidates as gas is absorbed from obstructed segments
    1. Lung parenchyma decreases in volume and becomes more dense
  2. Consolidated lung gradually becomes more visible on plain Chest XRay
    1. Consolidated lung density matches the density of soft tissue
    2. Obscures normal lung landmark structures (e.g. mediastinum, costophrenic angle)

III. Findings

  1. Mediastinal shift
    1. Massive whole lung collapse
    2. Lower lobe collapse
  2. Tracheal Deviation
    1. Occurs with whole lung collapse
    2. Trachea deviates toward the area of lung collapse
  3. Upward hilar displacement
    1. Upper lobe collapse
  4. Downward hilar displacement
    1. Lower lobe collapse
  5. Shift of fissures
    1. Affects any segment
    2. May shift from horizontal to vertical orientation
  6. Narrowing of costal interspaces
    1. Massive Atelectasis

IV. References

  1. Broder (2021) Crit Dec Emerg Med 35(6): 12-3

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