right middle lobe lung

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Right Middle Lobe Atelectasis; Endobronchial Squamous Cell Lung Cancer images, diagnosis, treatment options, answer review - Thoracic ImagingNo resultsNo resultsProcessing results.... Middle Right Background Lobe SyndromeThe middle lobe syndrome (RMLS) usually refers to chronic or recurrent in the right middle lobe of the lung. Described in medical literature in 1948, [] is caused by various etiologies and has no consistent clinical definition. The right mean lobe syndrome is characterized by a wedge-shaped density that extends before and below the hilum of the lung, which is best visualized using the lateral chest X-ray. See the image below. This condition is more common in children with a history or atody. Although the mechanism by which asthma leads to lobar atelectasis is unknown, the associated inflammation, bronchoespasm and secretions that cause the mucus plug are probably the main contributors. Management is determined by etiology, and most patients respond to medical therapy alone. PatophysiologyCertain anatomical characteristics make the right middle lobe susceptible to transient obstruction as a result offlam or edema. The narrow diameter of the lobar bronchus and the sharp angle of takeoff create bad conditions for drainage. Relative anatomical insulation of the medium lobe and the collateral poor ventilation decrease the chances of re-inflation once atelectasis occurs. Bronchial obstruction may result from extrinsic compression such as spinal lymphadenopathy or tumor of neoplastic origin; however, atelectasis in children usually results from a process such as edema associated with asthma and inflammation. The aspiration of the foreign body in the right middle orifice can also predispose the collapse of the lobe. Epidemiology Frequency United States The exact incidence of children is unknown. The right middle lobe syndrome is widely diagnosed and frequently unrecognized. Mortality/MorbidityLife in children varies from mild atelectasis and scarring of any consequence to severe bronchimiactasis that requires surgical resection, although this has become a rarity in the modern era. It has been said that middle-right lobe syndrome occurs twice more often in girls than in boys; however, large epidemiological studies are lacking. AgeThe symptoms begin in early childhood, usually in children 1-2 years old. The frequency of symptoms decreases in later childhood, but the interval between symptoms and diagnosis varies widely. Grandfather EA, BURFORD TH, MAYER JH. Middle lobe syndrome. Postgraduate Med. 1948 Jul. 4 (1):29-34. . Springer C, Avital A, Noviski N, et al. Role of infection in middle lobe syndrome in asthma. Arch Dis Child. 1992 May. 67(5):592-4. Gudbjartsson T, Gudmundsson G. The middle lobe syndrome: a review of clinicalopathological characteristics, diagnosis and treatment. Breathing. 2012. 84 (1):80-6. . Beydon N, Davis SD, Lombardi E, et al. An official statement by the Society of Thoracic Americana/European Respiratory Society: lung function tests in preschool children. Am J Respir Crit Care Med. 2007 Jun 15. 175 (12):1304-45. . Liu J, Chen SW, Liu F, Li QP, Kong XY, Feng ZC. Diagnosis of neonatal pulmonary atelectasa through pulmonary ultrasonography. Chest. 2015 Apr 1. 147(4):1013-9. . [Guideline] Institute for Clinical Systems Improvement (ICSI). Diagnosis and asthma management. 2008 Jan. Priftis KN, Mermiri D, Papadopoulou A, et al. The role of timely intervention in middle lobe syndrome in children. Chest. 2005 Oct. 128(4):2504-10. Halliday HL, Ehrenkranz RA, Doyle LW. Early (Ayed AK. Resection of the right middle lobe and languishing in children for the average lobe/lingula syndrome. Chest. 2004 Jan. 125(1):38-42. Brown M, Lemen R. Bronchiectasis. Kendig Breathing Tract Disorders in Children. Philadelphia, Pa: WB Saunders Co; 1998. 150-2. Priftis KN, Anthracopoulos MB, Mermiri D, et al. Bronchial hyperresponsibility, atopia, and bronchoalveolar eosinophils in persistent average lobe syndrome. Pediatr Pulmonol. 2006 Sep. 41(9):805-11. Torkian B, Kanthan R, Burbridge B. Diagnostic pitfalls in fine needle aspiration of solitary pulmonary nodules: two cases with radio-cyto-histological correlation. BMC Pulm Med. 2003 Sep 8. 3(1):2. . .Nemr S Eid, MD, FAAP, FCCP Professor of Pediatrics, University of Louisville School of Medicine; Director of Pediatric Pulmonary Medicine, Director of The Childhood Asthma Care and Education Center and the Cystic Fibrosis Center, Medical Director of Pediatric Respiratory Therapy, Kosair Children's Hospital Nemr S Eid, MD, FAAP, FCCP is a member of the following medical societies: , , , Disclosure: Nothing to reveal. Scott G Bickel, MD, MS Assistant Professor of Pediatrics, Division of Pediatric Pulmonology, University of Louisville School of Medicine Scott G Bickel, MD, MS is a member of the following medical societies: , , Disclosure: Nothing to reveal. Michelle Eckerle University of Louisville School of Medicine Michelle Eckerle is a member of the following medical societies: Disclosure: Nothing to reveal. Mary L Windle, PharmD Adctjun Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Nothing to reveal. Denise Serebrisky, MD Associate Professor, Department of Pediatrics, Albert Einstein College of Medicine; Director, Division of Pulmonary Medicine, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center/North Central Bronx Hospital; Director, Jacobi Asthma and Alergy Center for Children, Jacobi Medical Center Denise Serebrisky, MD is a member of the following medical societies: Disclosure: Nothing to reveal. Thomas Scanlin, MD Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School Thomas Scanlin, MD is a member of the following medical societies: , , , , Disclosure: Nothing to reveal. Heidi Connolly, MD Associate Professor of Pediatrics and Psychiatry, University of Rochester School of Medicine and Dentistry; Director, Pediatric Sleep Medicine Services, Strong Sleep Disorders Center Heidi Connolly, MD is a member of the following medical societies: , , and Disclosure: Nothing to reveal. What do you want to print? Find us aboutMembershipWebMD NetworkEditions

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