Mucus Impaction

Mucus Impaction

Description, Causes and Risk Factors:

Mucus impaction is a relatively common finding at chest radiography and computed tomography (CT) and is associated with a wide variety of diseases. The disease processes that may cause mucoid impaction have been variously categorized as obstructive versus nonobstructive or congenital versus acquired.

Mucus Impaction

Both congenital and acquired abnormalities may cause mucus impaction of the large airways that often manifests as tubular opacities known as the finger-in-glove sign. The congenital conditions in which this sign most often appears are segmental bronchial atresia and cystic fibrosis. The sign also may be observed in many acquired conditions, include inflammatory and infectious diseases (allergic bronchopulmonary aspergillosis, broncholithiasis, and foreign body aspiration), benign neoplastic processes (bronchial hamartoma, lipoma, and papillomatosis), and malignancies (bronchogenic carcinoma, carcinoid tumor, and metastases).

Etiology includes cystic fibrosis, immunodeficiencies, aspiration of foreign objects, and ciliary dyskinesia. Bronchial dilatation is represented on chest radiographs by irregular peripheral opacities in association with the classic linear opacities described as tramlines. Although CT is superior in depicting small mucous plugs inside the airways, it is rarely required for confirmation.

Risk Factors:

  • Segmental bronchial atresia.
  • Bronchiectasis.
  • Allergic bronchopulmonary aspergillosis.
  • Foreign body aspiration.
  • Endobronchial hamartoma.
  • Papillomatosis.
  • Carcinoid tumor.
  • Bronchogenic carcinoma.
  • Endobronchial metastases.


Mucus impaction symptoms may accompany other symptoms affecting the respiratory system including:

  • Cough.
  • Cough that gets more severe over time.
  • Coughing up clear, yellow, light brown, or green mucus.
  • Rapid breathing (tachypnea) or shortness of breath.
  • Runny nose (nasal congestion).
  • Shortness of breath (SOB).
  • Sneezing.
  • Sore throat.
  • Wheezing (whistling sound made with breathing).


The differential diagnosis (DD) is broad and includes both congenital and acquired abnormalities. In the setting of a central mucoid impaction, bronchogenic carcinoma must always be excluded.

To point the correct diagnosis, the radiologist must be familiar with the key radiographic and CT features that enable differentiation among the various likely causes. CT is more useful than chest radiography for differentiating between mucus impaction and other disease processes, such as arteriovenous malformation, and for directing further diagnostic evaluation. In addition, knowledge of the patient's medical history, clinical symptoms and signs, and predisposing factors is important.

When mucus and other secretions are retained in bronchioles and nondilated airways, the radiographic appearance typically is normal; any abnormal features may be subtle and easily overlooked. However, even in these cases, thin-section chest CT may depict branching and tree-in-bud opacities. The possible causes of the tree-in-bud pattern are well described elsewhere.


If you're a smoker, cut the habit. Everyone knows that smoking aggravates and promotes several lung and bronchial problems. As if body infections are not enough, respiratory diseases caused by smoking will give your body additional health issue baggage it does not need. Smoking interferes with your body's ability to fight off any infection, so whatever problems it is currently engaged in that resulted in the formation of mucous will be prolonged. Thus, your phlegm problem will drag on longer. Smoking also kills the cilia that line your lungs, making it harder for you to cough out phlegm. If you've been coughing up brown or gray-colored phlegm, it means that your body is screaming for you to lay off the cigarettes. It would do you well to cut out the filthy habit before those browns and grays become speckled with red - a sure precursor to something serious, like lung cancer.

Treat any nasal or sinus infection that you have. As mentioned earlier, phlegm is just an accumulation of mucus and other dead substances that coagulate and become visible. Mucous isn't a foreign object - your body's airways produce mucous regularly. These mucus secretions don't accumulate because they're regularly cleared to your throat where they are carried down by the saliva. If you have an infection that blocks normal passage to the airways and throat, the mucus doesn't get drained down by the saliva and thus accumulates. Fixing the infection will help fix the additional congestion, easing the accumulation of mucus and phlegm.

Take an expectorant. Expectorants are medicines you can take to clear and loosen up any mucus and phlegm in your respiratory tract. They work by thinning out the mucus so you will be able to easily dislodge it when you cough. Common expectorant medicines are those that contain guaifenesin and bromhexine, so when buying expectorants, be sure to check if these ingredients are present. As with buying any medicine over the counter, be sure to consult with your physician first, just in case you might be subject to complications because of them.

Don't take cough suppressants. Sure, it is pretty annoying when you have a hacking cough every five minutes, causing you to spit out phlegm at pretty much the same rate, but coughing is your body's way of trying to dislodge the phlegm. If you're taking cough suppressants or anything that inhibits your ability to cough, you're essentially allowing the production and build-up of mucus and phlegm in your system since you've basically shut down your body's mechanism to expel them. The sooner you get all the phlegm out of your system, the sooner your coughing will stop, and the sooner you will find relief.

Drink plenty of fluids and liquids. Plenty of liquids and fluids help loosen up any hard, sticky phlegm that is congesting your system. Fluids also help wash down mucus that is regularly deposited on your throat, thereby lessening their chances of building up and coagulating. There are also herbal teas and drinks that help you deal with respiratory problems, and the fewer complications you have, the better your chances of getting rid of respiratory disease effects - mucus and phlegm included.

Spit the phlegm out; don't swallow it. Among the many components that make up phlegm are substances like immunoglobulins and glycoproteins that help your body fight off the infection. When these substances get killed (together with the bacteria and virus they were fighting), they become part of what makes up phlegm. When phlegm gets coughed out, it means that they have served their purpose - remnants and refuse of the battle, so to speak - and are no longer necessary in the proper functioning of the body. They have to be expelled. Therefore, spit them out and don't swallow them back. Aside from the fact that swallowing phlegm is gross and unsanitary, it sometimes gets reintroduced to your pulmonary system, worsening your situation.

There are also home brew remedies you can try that will help in getting rid of your phlegm. Eucalyptus oil mixed with boiling water is a good way to decongest your chest and lessen the abundance of phlegm in your respiratory system. Two to three drops of the oil in boiling water should be enough to do the trick. Hold a towel over your head and deeply breathe in the steam. This will help clear out congested passageways of your respiratory tract, allowing you to spit out the phlegm more easily. Garlic is also said to have expectorant properties and is considered to be a good supplement for treating congestion.

When your phlegm starts showing up in different colors, it's about time to have yourself checked by a physician. Take a sample of your phlegm for analysis. Different colors usually indicate an underlying condition. Normal phlegm is usually clear and white. Yellow phlegm means that your immune system is functioning properly and is responding to something. Greenish phlegm means that there is definitely an infection in your body. Rusty spots in green phlegm are often an indication of something serious, like internal respiratory micro-bleeding or pneumonia. Brownish phlegm can be a sign of infection, as well as symptoms of too much smoking, as a resin is sticking to the phlegm. When this happens, it is always advisable to limit or just stop your smoking habit, as it may be exacerbating whatever respiratory condition you may have.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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