Pulmonary consolidation

Updated on Nov 09, 2023

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DiseasesDB 10949

A pulmonary consolidation is a region of (normally compressible) lung tissue that has filled with liquid, a condition marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. Simply, it is defined as alveolar space that contains liquid instead of gas. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). It must be present to diagnose pneumonia: 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 side with consolidation

Percussion is dull in affected area

Breath sounds are bronchial

Possible medium, late, or pan-inspiratory crackles

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 in the healthy lung where speech sounds muffled.

A pleural rub may be present.

A lower expected Pa02 than calculated in the alveolar gas equation

Radiology

Typically, an area of white lung is seen on a standard X-ray. Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.

References

Pulmonary consolidation Wikipedia

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Contents

Signs

Radiology

References