Bulging fissure sign (lobar consolidation)

Changed by Ashesh Ishwarlal Ranchod, 11 Oct 2023
Disclosures - updated 19 Dec 2022: Nothing to disclose

Updates to Article Attributes

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The bulging fissure sign refers to lobar consolidation where the affected portion of the lung is expanded, causing displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging (sagging) fissure sign. Classically, it has been described in right upper lobe (RUL) consolidation secondary to Klebsiella pneumonia. It is now rarely seen due to prompt antibiotic therapy for suspected pneumonia.

The most common infective causative agents are 1:

Other uncommon agents are:

It may also be seen with:

See also

  • -<p>The <strong>bulging fissure sign</strong> refers to <a href="/articles/lobar-consolidation">lobar consolidation</a> where the affected portion of the lung is expanded, causing displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging (sagging) fissure sign. Classically, it has been described in <a href="/articles/right-upper-lobe-consolidation">right upper lobe (RUL) consolidation</a> secondary to <a href="/articles/klebsiella-pneumonia">Klebsiella pneumonia</a>. It is now rarely seen due to prompt antibiotic therapy for suspected pneumonia.</p><p>The most common infective causative agents are <sup>1</sup>:</p><ul>
  • -<li>
  • -<em>Streptococcus pneumoniae: </em>pneumococcal pneumonia</li>
  • -<li>
  • -<em>Klebsiella pneumoniae: </em><a href="/articles/klebsiella-pneumonia">Klebsiella pneumonia</a>
  • -</li>
  • -<li>
  • -<em>Pseudomonas aeruginosa:</em> <a href="/articles/pseudomonas-pulmonary-infection">pseudomonas pulmonary infection</a>
  • -</li>
  • -<li><em>Staphylococcus aureus</em></li>
  • -</ul><p>Other uncommon agents are:</p><ul>
  • -<li>
  • -<em>Legionella pneumophila </em><sup>3</sup> : <a href="/articles/legionella-pneumonia">legionella pneumonia</a>
  • -</li>
  • -<li>
  • -<em>Mycobacterium tuberculosis</em> </li>
  • -</ul><p>It may also be seen with:</p><ul>
  • -<li>
  • -<a href="/articles/adenocarcinoma-in-situ-minimally-invasive-adenocarcinoma-and-invasive-adenocarcinoma-of-lung-1">lung adenocarcinoma</a> <sup>4</sup>
  • -</li>
  • -<li><a href="/articles/lung-abscess">lung abscess</a></li>
  • -<li><a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a></li>
  • +<p>The <strong>bulging fissure sign</strong> refers to <a href="/articles/lobar-consolidation">lobar consolidation</a> where the affected portion of the lung is expanded, causing displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging (sagging) fissure sign. Classically, it has been described in <a href="/articles/right-upper-lobe-consolidation">right upper lobe (RUL) consolidation</a> secondary to <a href="/articles/klebsiella-pneumonia">Klebsiella pneumonia</a>. It is now rarely seen due to prompt antibiotic therapy for suspected pneumonia.</p><p>The most common infective causative agents are <sup>1</sup>:</p><ul>
  • +<li>
  • +<em>Streptococcus pneumoniae: </em>pneumococcal pneumonia</li>
  • +<li>
  • +<em>Klebsiella pneumoniae: </em><a href="/articles/klebsiella-pneumonia">Klebsiella pneumonia</a>
  • +</li>
  • +<li>
  • +<em>Pseudomonas aeruginosa:</em> <a href="/articles/pseudomonas-pulmonary-infection">pseudomonas pulmonary infection</a>
  • +</li>
  • +<li><em>Staphylococcus aureus</em></li>
  • +</ul><p>Other uncommon agents are:</p><ul>
  • +<li>
  • +<em>Legionella pneumophila </em><sup>3</sup> : <a href="/articles/legionella-pneumonia">legionella pneumonia</a>
  • +</li>
  • +<li>
  • +<em>Mycobacterium tuberculosis</em> </li>
  • +</ul><p>It may also be seen with:</p><ul>
  • +<li>
  • +<a href="/articles/adenocarcinoma-in-situ-minimally-invasive-adenocarcinoma-and-invasive-adenocarcinoma-of-lung-1">lung adenocarcinoma</a> <sup>4</sup>
  • +</li>
  • +<li><a href="/articles/lung-abscess">lung abscess</a></li>
  • +<li><a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a></li>
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Case 3: squamous cell carcinoma of the lung
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