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Causes
By Mayo Clinic staffAtelectasis may be the result of a blocked airway (obstructive atelectasis) or of pressure outside your lung (nonobstructive atelectasis). To understand how it occurs, think of soap bubbles. Just as a soap bubble's liquid surface keeps the bubble intact, a surface agent (surfactant) coats each of the tiny air sacs (alveoli) in your lungs so they don't collapse. Anything that diminishes surfactant, such as pressure on the lungs, can cause atelectasis.
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, is the most common cause of atelectasis. Drugs given during surgery make the lungs inflate less fully than they ordinarily do, 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, most commonly a peanut, into their lungs.
- Narrowing of major airways from disease. Tuberculosis and other diseases that involve the major airways can cause them to narrow.
- Tumor in a major airway. A cancer or a benign growth can narrow the airway.
- Blood clot. This occurs only if there's significant bleeding into the lungs that can't be coughed out.
Pressure on the outside of your lungs can cause nonobstructive atelectasis. Possible causes include:
- Injury. Chest trauma — from a fall or car accident, for example — can damage and compress your lungs.
- Pleural effusion. This is a buildup of fluid between the tissues (pleura) that line the lung and the inside of the chest wall.
- Pneumonia. Different types of pneumonia, an inflammation of your lungs, temporarily can cause nonobstructive as well as obstructive atelectasis. An atelectatic lung that remains collapsed for a few weeks or more can result in bronchiectasis (brong-ke-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. Certain large tumors can put pressure on the lung, as opposed to blocking the air passages.
- Ali J. Perioperative respiratory failure. In: Hall JB, et al. Principles of Critical Care. 3rd ed. New York, N.Y.: McGraw-Hill Medical Pub. Division; 2005. http://www.accessmedicine.com/content.aspx?aID=2296794. Accessed Jan. 26, 2010.
- Stark P. Atelectasis: Types and pathogenesis in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 11, 2010.
- Finder JD. Atelectasis in children. http://www.uptodate.com/home/index.html. Accessed Jan. 11, 2010.
- Surka A, et al. Bronchoscopic myths and legends: Bronchoscopy in the treatment of lobar atelectasis. Clinical Pulmonary Medicine. 2007;14:302.
- Smith DA. Pulmonary emergencies. In: Stone CK, et al. Current Diagnosis & Treatment: Emergency Medicine. 6th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3106264. Accessed Jan. 26, 2010.
- Atelectasis. In: Professional Guide to Diseases. 8th ed. Springhouse, Pa.: Wolters Kluwer Health; 2005.
- Rozenfeld RA. Atelectasis. In: Kleigman, et al. Nelson's Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders; 2007. http://www.mdconsult.com/das/book/body/181644491-2/0/1608/959.html?tocnode=54482623&fromURL=959.html#4-u1.0-B978-1-4160-2450-750409-6_7886. Accessed Feb. 3, 2010.
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