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PATHOGENESIS OF POSTOPERATIVE PULMONARY ATELECTASIS:  An Experimental Study

RANDOLPH T. SHIELDS Jr., M.D.
Arch Surg. 1949;58(4):489-503. doi:10.1001/archsurg.1949.01240030497009.
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ONE OF the most discouraging complications confronting a surgeon is the clinical entity commonly called postoperative pulmonary atelectasis. By postoperative atelectasis reference is made to that pulmonary complication which occurs within the first two or three postoperative days. This condition is accompanied with actual obstruction within the bronchial tree. The classic signs and symptoms of this condition include fever, leukocytosis, cough, purulent or tenacious sputum and an area in the lung of dulness to percussion and of diminished or absent breath sounds. The classic roentgenographic findings include diminution in lung volume, displacement of the mediastinum and narrowing of the overlying intercostal spaces.

Postoperative atelectasis should be differentiated from postoperative pneumonia, which may give rise to the same symptoms and even the same physical signs, before actual consolidation occurs. Clinically, a roentgenogram of the chest taken in expiration may differentiate the two conditions.1 However, there are undoubtedly many combinations of

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