Trapped lung: a review of literature and recent cases

Abstract

A trapped lung, one that cannot expand due to a restrictive fibrous visceral pleural peel, is caused by malignancy, chest trauma, thoracic surgery, complicated infection, and autoimmune conditions. Suspicion for and evaluation of this condition should be considered early on in a patient with history of the above conditions that presents with a chronic pleural effusion of stable volume. Diagnosis is reached 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 is dependent on symptomatology and overall patient condition, and ranges from observation to fluid removal, fibrinolytic therapy, talc pleurodesis, indwelling pleural catheter, and surgical decortication. A review of English literature from the last 10 years including case reports, case series, and observational reviews was conducted. A majority of these patients presented with trapped lung due to malignancy, infection, or autoimmune conditions. Treatment varied depending on the cause of the trapped lung, underlying conditions, and patient preference; a majority of these patients received either pleurodesis, intrapleural fibrinolytic therapy, or surgical decortication.

A primary pleural hydatid cyst was discovered months after an undiagnosed pneumothorax: A diagnostic and therapeutic dilemma in a rare case report from Syria

“…The most common cause of trapped lung in the past was a therapeutic pneumothorax for treating tuberculosis. Some of the current common causes are autoimmune pleurisy, complex parapneumonic effusion, chest trauma, thoracic radiation, and uremia [ 16 ]. Another condition associated with non-expandable lungs is pleural fibrosis, which occurs as a natural response to the presence of inflammation, malignancy, or other diseases such as tuberculosis [ 17 ].…”