Right middle lobe atelectasis in childhood asthma

Abstract

Three cases of reversible atelectasis of the right middle lobe, which occurred within a short period of time in children hospitalized for acute bronchial asthma, are reported. By frequent roentgenologic monitoring of the pulmonary findings the collapse of this vulnerable lobe can be detected early and, by vigorous therapy, re-expansion of the atelectatic lobe can be achieved; otherwise the atelectasis might lead to long-standing disease in the nonaerated lung areas. The clinical entity of right middle lobe collapse as a result of severe bronchial asthma is contrasted with the often referred to “right middle lobe syndrome” which constitutes either a structural anomaly of the right middle lobe bronchus itself or its compression by grossly enlarged lymph nodes surrounding the origin of that bronchus. This differentiation is considered to be important since the latter condition often warrants surgical intervention, while the former should respond to competent antiasthmatic management. Without continued vigilance, however, long-standing atelectasis of any lobe from any cause may lead to permanent damage to the involved tissue, primarily bronchiectasis and lung abscesses, and eventually require lobectomy.