CTICasesShifting Lobar Atelectasis and Pneumothorax ex Vacuo
Imaging findings
Serial chest radiographs show rapid, sequential collapse and re-expansion of different lobes (e.g., right middle lobe atelectasis resolving, followed by left lower lobe atelectasis), associated with a transient, non-progressive pleural gas collection.
Key takeaways
Shifting lobar atelectasis is typically caused by mobile mucous plugs in patients with asthma or poor secretion clearance. Acute lobar collapse can create severe localized negative intrapleural pressure, drawing air into the pleural space (pneumothorax ex vacuo) without a visceral pleural tear. It resolves once the airway is cleared.
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