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Correspondence |
The Editor—Sir,
I enjoyed looking at the illustrations in the recent pictorial review on lobar atelectasis by Ashizawa et al [1] published in this journal.
What worries me is the use of the term "atelectasis" in the title and throughout the text. In my understanding, the term atelectasis (
=imperfect, 
=expansion) refers to collapse that has been present since birth, i.e. when the lung has never expanded [2]. Why not use the simpler and more correct word "collapse"? "Collapse" did not appear except in some of the references [3–6]. I feel the simple term collapse (usually short for absorption collapse) should always be used for clarity. An alternative would be the term "reduced volume".
According to an old "Medical Vocabulary" by Mayne and Mayne [7], which I obtained several years ago, Dr Jorg of Leipzig first gave the name atelectasis to a "condition in new-born children which may last for days or weeks." To a purist, therefore, the term atelectasis thus refers to a congenital condition, i.e. neonatal collapsed lung!
Fraser and Paré [8] stated that atelectasis (with qualifiers — mild, moderate or severe) is preferable to collapse in describing loss of volume and that collapse connotes total atelectasis in which lung tissue has been reduced to its smallest volume. I do not believe this to be correct and indeed this point is well shown in some of the examples used by Ashizawa et al [1], where the collapsed lobe retains considerable volume, particularly when the bronchus is blocked by cancer. Fraser and Paré [8] rather awkwardly tried to get over the problem in the neonate by terming failure of lung expansion as "anectasis". Did the authors fully check the reference, as they also misquoted the authors of the 3rd edition of this work?
Woodring and Reed [9, 10] and the Fleischner Society [11] equate atelectasis with collapse, without apparently considering the real meaning of the term.
I always ask registrars and others if they imply a congenital origin of collapse when they use the word atelectasis, and am almost always told they do not. A few know the difference! So, apparently, did the authors of some of the papers quoted by Ashizawa et al [3–6] who used the word collapse.
What is wrong with the English term collapse, which appears to be more correct? It is easily qualified by partial, complete, lung, lobar, segmental, subsegmental or linear, cicatricial, absorption, etc.
Yours etc.,
Charfield, Cassington Road, Eynsham, Oxford OX8 1LH, UK
Footnotes
See the author's reply on page 875
Received for publication February 27, 2001. Accepted for publication April 4, 2001.
References
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