CSS ATELECTASIS SUSIN.pptx

8/22/2019 CSS ATELECTASIS SUSIN.pptx

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CASE CLINICAL SESSION

ATELECTASIS

SMF RADIOLOGI

PROGRAM PENDIDIKAN PROFESI DOKTER (P3D)

FAKULTAS KEDOKTERAN UNISBA

RSUD AL IHSAN BANDUNG

2012

Oleh :

Yaniar SusinKelompok 2 Angk. 5


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DEFINISI

Suatu keadaan paru atau

sebagian paru yang

mengalami hambatan

berkembang secara

sempurna sehingga aerasi

paru berkurang atau sama

sekali tidak berisi udara


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Normal lung volumes and fissures.Frontal (A) and lateral (B) views of the chest show normal

positions of the minor (horizontal, right-sided) and major

(oblique, bilateral) fissures. The major fissures are often

superimposed on the lateral chest radiograph and are

usually not seen on the frontal view.


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Relaksasi /Kompresif/

Pasif

Absorbsi/Obstruktif/Resorbsi

Adesif

Sikatrik /Kontraksi

BERDASARKANMEKANISME :


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Relaksasi / Kompresi / Pasif

- Adanya akumulsi udara / cairan di rongga

pleura

- Karena pneumothorax; efusi pleura; hernia

difragmatika


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Absorbsi / Obstruktif / Resorpsi

- Ada obstruksi atau oklusi lumen bronkus

disertai absorbsi udara di jaringan paru

bag. Distal

- Sumber obstruksi :

a. Dalam bronkus : tumor bronkus, benda

asing, bronkial stricture, cairan sekresi yg

masif

b. Luar bronkus : tumor sekitar bronkus,

kelenjar membesar(KGB)


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Adesif

- Akibat gangguan pada surfaktan

- Pada ADRS, HMD, emboli paru


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Sikatrik / Kontraksi

- Akibat proses fibrosis pada paru atau

pleura --- membuat paru menjadi kaku ---

compliance paru --- expansi paru

terhambat

- Pada Tb, histoplasmosis


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GAMBARAN RADIOLOGIS

PrimarySign

Perubahan letak fisura interlobaris

Hipoaerasi --- densitas --- radiopaque

Corakan bronkovaskular

Secondarysign

Elevasi diafragma

Pergeseran mediastinum

Pergeseran trakea Pergeseran letak hilus

Hiperaerasi kompensasi paru yang N

Penyempitan sel iga


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2) ATELEKTASIS SEGMENTAL

KLASIFIKASI

a. Atelektasis lobaris bawah

b. Atelektasis lobaris tengah

c. Atelektasis lobaris atas

1) ATELEKTASIS LOBAR

3) ATELEKTASIS LOBULARIS


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Atelektasis lobaris bawah

Left lower lobe atelectasis.A: Frontal view of the chest shows loss of the medialleft hemidiaphragm border, elevation of the left hemidiaphragm, and increased

opacification of the left medial lower lung (stippled area). B: Lateral view shows

increased opacification of the posterior inferior lung (stippled area).


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Jika terjadi di kiri : diafragma akanterlihat lebih tinggi

Traksi fisura mayor


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Left lower lobe

Collapse

PA chest radiograph of a

65-year-old woman

shows

inferior displacement

of the left major fissure

(arrows) and a

triangular area of

abnormal opacityprojected over the left

heart.


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Lateral view shows :

abnormal opacity overlying

the lower spine (circle), the

so-called spine sign.


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Atelektasis lobaris tengah

Right middle lobe atelectasis.A: Frontal view of the chest shows loss of the right

heart border and an ill-defined area of increased opacification in the right medial lung

(stippled area). B: Lateral view shows triangular area of opacification (black area)

overlying the heart, with approximation of the minor and major fissures.


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Disebabkan

peradanganataupenekanan

bronkus olehKGB besar

Bayanganberbentuktriangular

sebelahjantung

Silhouttesign (+)


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Right middle lobe

segmental collapse

PA chest radiograph of a 52-year-

old woman with shortness of

breath and cough shows :

hazy opacity in the right medial

lung and loss of the right heart

border.


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linear opacity overlying the

heart (arrows),

representing the collapsedright middle lobe.


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Atelektasis lobaris atas

Right upper lobe atelectasis. A: Frontal view of the chest shows elevation of the

minor fissure and increased opacification of the right upper medial lung (black

area). B: Lateral view shows elevation of the minor fissure and superior portion of

the right major fissure, as well as opacification of the upper lung.


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Bayangan densitas tinggi

Penarikan fissura interlobariske atas (fisur minor terangkat)

Trakea tertarik ke lesi

Hillus tertarik ke atas


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Right upper lobe

segmental atelectasis

Posteroanterior (PA) chest

radiograph of a 35-year-old man

with lithoptysis (literally

coughingup stones,but

representing calcified lymph nodes

that have eroded into the airway,usually secondary to tuberculosis

or histoplasmosis) shows :

partial collapse of the right

upper lobe. The minor fissure is

elevated (arrows), outlining the

inferior margin of the opacified,atelectatic lung. Note calcified

densities (arrowheads)

overlying the opacified lung

centrally and peripherally.


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elevation of the minor

fissure (arrows) outlining

the inferior margin of theopacified, atelectatic right

upper lobe


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ATELEKTASIS SEGMENTALIS

Sulit dikenali dg foto PA

Terdapat pereselubungan

Penarikan fisura interlobaris


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Triangular

(segmental)

Anteroposterior

opacity in the lower

field. This sits directly

on the diaphragm


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Triangular

(segmental)

Lateral opacity in thelower field. This sits

directly on the

diaphragm.


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ATELEKTASIS LOBULARIS

Penyumbatan di bronkus kecil

Bayangan horizontal tipis, biasanya di base

penurunan volume paru yg cukup besar

pergeseran struktur rongga dada

Fleischners line


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Pneumoni Efusi Pleura Atelektasis

ada penarikan

mediastinum

Air bronchogram (+)

Interkostal spacemasih N

Iga normal

Meniskus sign (-)

Ada penarikan

mediastinum ke arahN

Air bronchogram (-)

Interkostal spacelebih lebar di bag.

Lesi

Iga melebar danlebih datar

Meniskus sign (+)

Ada penarikan

mediastinum ke arahlesi

Air bronchogram (-)

Interkostal spacemasih lebih sempit di

bag lesi

Iga menyempit danlebih miring

Meniskus sign (-)


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TERIMAKASIH


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