Trapped Lung

Excerpt

Non-expandable lung (NEL) is a term used to describe entities that are characterized by the inability of the lung to expand into the chest cavity or respective pleural space. There are three distinct causes of NEL: a) An endobronchial lesion obstructing the lumen of the bronchus leading to the distal lobar collapse, b) chronic atelectasis, and c) visceral pleural restriction due to pleural disease resulting in the trapped lung. The trapped lung, first described in 1967, is a clinical entity that is characterized by the presence of a restrictive visceral pleura.

Trapped lung occurs as a mature fibrous strip encircles the visceral pleura restricting the lung expansion, which develops from inflammatory sequelae. The usual primary causes of pleural inflammation are pneumonia or hemothorax, but other causes like pneumothorax, thoracic surgical interventions, uremia, autoimmune diseases like rheumatoid pleuritis are also well established.

In clinical practice, a patient with trapped lung commonly presents with chronic pleural effusion. Repeated thoracenteses, without lung re-expansion post-procedure, can result in adverse events.