Trapped lung
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Trapped lung is, also known as unexpandable/unexpanded lung, is a term given to a situationused where there is non expandable-expandable lung post fluid removal, often thoracocentesis. It is similar to but not entirely synonymous with the term lung entrapment.
Pathology
Trapped lung develops as a sequelae of remote pleural space inflammation resulting in the development of a mature, fibrous membrane that impedes the lung expansion duringfrom re-expanding. This creates a negative pressure environment in the pleural space, which is filled with fluid removalcreating a pleural effusion. It is similar to butDrainage of this pleural fluid will often result in a pneumothorax from parenchymal-pleural fistulas.
Radiographic features
Plain film
Commonly noted associated with post-thoracentesis pneumothorax, and may have the following features 4:
- visceral pleural peel (thickening)
- basal pneumothorax
- ipsilateral volume loss
- lobar atelectasis
Pneumothoraces, if present, typically do not entirely synonymous with the term lung entrapment
Differential diagnosis
General considerations include 1:
-<p><strong>Trapped lung</strong> is a term given to a situation where there is non expandable lung as a sequelae of remote pleural space inflammation resulting in the development of a mature, fibrous membrane that impedes lung expansion during fluid removal. It is similar to but not entirely synonymous with the term <a href="/articles/lung-entrapment">lung entrapment</a>.</p>- +<p><strong>Trapped lung</strong>, also known as <strong>unexpandable</strong>/<strong>unexpanded lung</strong>, is a term used where there is non-expandable lung post fluid removal, often thoracocentesis. It is similar to but not entirely synonymous with the term <a href="/articles/lung-entrapment">lung entrapment</a>.</p><h4>Pathology</h4><p>Trapped lung develops as a sequelae of remote pleural space inflammation resulting in the development of a mature, fibrous membrane that impedes the lung from re-expanding. This creates a negative pressure environment in the pleural space, which is filled with fluid creating a pleural effusion. Drainage of this pleural fluid will often result in a pneumothorax from parenchymal-pleural fistulas. </p><h4>Radiographic features</h4><h5>Plain film</h5><p>Commonly noted associated with post-thoracentesis <a href="/articles/pneumothorax">pneumothorax</a>, and may have the following features <sup>4</sup>: </p><ul>
- +<li>visceral pleural peel (thickening)</li>
- +<li>basal pneumothorax</li>
- +<li>ipsilateral volume loss</li>
- +<li><a href="/articles/lobar-lung-collapse">lobar atelectasis</a></li>
- +</ul><p>Pneumothoraces, if present, typically do not appear larger on expiratory images <sup>1</sup>.</p><h4>Differential diagnosis</h4><p>General considerations include <sup>1</sup>:</p><ul>
- +<li>obstructing <a href="/articles/lung-cancer-3">bronchogenic carcinoma</a>
- +</li>
- +<li><a href="/articles/cryptogenic-organising-pneumonia-1">cryptogenic organising pneumonia</a></li>
- +<li>
- +<a href="/articles/cryptogenic-organising-pneumonia-1">organising pneumonia</a> </li>
- +</ul><p> </p><p> </p>
References changed:
- 4. Heidecker J, Huggins JT, Sahn SA et-al. Pathophysiology of pneumothorax following ultrasound-guided thoracentesis. Chest. 2006;130 (4_MeetingAbstracts): 1173-84. <a href="http://dx.doi.org/10.1378/chest.130.4.1173">doi:10.1378/chest.130.4.1173</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17035453">Pubmed citation</a><span class="auto"></span>
- 3. McDermott S, Levis DA, Arellano RS. Chest drainage. Semin Intervent Radiol. 2012;29 (04): 247-55. <a href="http://dx.doi.org/10.1055/s-0032-1330058">doi:10.1055/s-0032-1330058</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577621">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/24293797">Pubmed citation</a><span class="auto"></span>
Image 1 X-ray (Frontal) ( create )
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