A pulmonary consolidation is a region of normally compressible
lung tissue that has filled with liquid instead of air. The condition is marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a
radiologic sign
A radiologic sign is an objective indication of some medical fact (that is, a medical sign) that is detected by a physician during radiologic examination with medical imaging (for example, via an X-ray, CT scan, MRI scan, or sonographic scan). ...
. Consolidation occurs through accumulation of inflammatory cellular exudate in the
alveoli Alveolus (; pl. alveoli, adj. alveolar) is a general anatomical term for a concave cavity or pit.
Uses in anatomy and zoology
* Pulmonary alveolus, an air sac in the lungs
** Alveolar cell or pneumocyte
** Alveolar duct
** Alveolar macrophage
* M ...
and adjoining ducts. The liquid can be
pulmonary edema
Pulmonary edema, also known as pulmonary congestion, is excessive liquid accumulation in the tissue and air spaces (usually alveoli) of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure. It is due ...
, inflammatory
exudate
An exudate is a fluid emitted by an organism through pores or a wound, a process known as exuding or exudation.
''Exudate'' is derived from ''exude'' 'to ooze' from Latin ''exsūdāre'' 'to (ooze out) sweat' (''ex-'' 'out' and ''sūdāre'' 'to ...
,
pus, inhaled water, or blood (from bronchial tree or
hemorrhage
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, v ...
from a
pulmonary artery
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and ...
). Consolidation must be present to diagnose
pneumonia
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severit ...
: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation.
[
]
Signs
Signs that consolidation may have occurred include:
*Expansion of the thorax on inspiration is reduced on the affected side
* Vocal fremitus is increased on the affected side
*Percussion is dull in the affected area
*Breath sounds are bronchial
*Possible medium, late, or pan-inspiratory crackles
Crackles are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation. They are usually heard only with a stethoscope ("on auscultation"). Pulmonary crackles are a ...
* Vocal resonance is increased. Here, the patient's voice (or whisper, as in whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to the healthy lung where speech sounds muffled.
*A pleural rub may be present.[
*A lower PAO2 than calculated in the ]alveolar gas equation The alveolar gas equation is the method for calculating partial pressure of alveolar oxygen (PAO2). The equation is used in assessing if the lungs are properly transferring oxygen into the blood. The alveolar air equation is not widely used in ...
Diagnosis
Radiology
* Typically, an area of white lung is seen on a standard X-ray.radiography
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeu ...
and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of ...
infections.
See also
* Pulmonary infiltrate
References
External links
{{Radiologic signs
Medical terminology
Radiologic signs