Divya Vangipuram Wyatt MD
A trapped lung, one that cannot expand due to a restrictive fibrous visceral pleural peel, is caused by malignancy, chest trauma, thoracic surgery, complicated infections, and autoimmune disorders. Suspicion for and evaluation of this condition should be considered early in patients with a history of the above disorders who present with a chronic pleural effusion of stable volume. The diagnosis is established with pleural fluid analysis, manometry that shows negative intrapleural pressure that is further reduced with fluid aspiration, and imaging that shows a chronic effusion and pleural thickening. Treatment depends on symptoms and the patient’s overall condition and ranges from observation to fluid removal, fibrinolytic therapy, talc pleurodesis, indwelling pleural catheter placement, and surgical decortication. A review of English literature from the last 10 years, including case reports, case series, and observational reviews was conducted. The majority of these patients presented with trapped lung due to malignancy, infection, or autoimmune disorders. Treatment varied depending on the cause of the trapped lung, underlying comorbidities, and patient preference; a majority of these patients underwent either pleurodesis, intrapleural fibrinolytic therapy, or surgical decortication.
Keywords: Trapped lung, fibrous visceral pleural peel, malignant pleural effusion, pleurodesis, decortication
Article citation: Divya Vangipuram Wyatt D. Trapped lung: A review of literature and recent cases. The Southwest Respiratory and Critical Care Chronicles 2023;11(46):25–33
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
Conflicts of interest: none
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