Chronic atelectasis
(middle lobe syndrome, Mittellappensyndrom)

General information:

  • Missing lung expansion over a period of at least 2-3 weeks due to bronchial stenosis (slit fashioned bronchi, malformation of the bronchial wall, compression from outside by enlarged lymph nodes or vascular anomalies) or intraluminal bronchial obstruction (foreign body).

Symptoms:

  • Asymptomatic.
  • Recurrent signs of pulmonary infections.
  • Chronic cough.

Diagnostic workout:

  • Thoracic X-ray or CT scan.
  • Bronchoscopy.
  • Ventilatory and perfusion scintigraphy.
Typical right middle lobe atelectasis
Typical right middle lobe atelectasis

Indication for operation:

  • No improvement after intensive conservative treatment over a period of 8 weeks.

Treatment/Operation:

  • Resection, e.g. middle lobe lobectomy.

Postoperative management:

  • Chest tubes may be removed if the lung is fully expanded and drainage volumes decrease below 20 to 50cc during a 24 hour period.

Prognosis:

  • Good.
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