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Lung Contusion and Laceration
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Lung contusion: Blunt chest trauma → alveolar capillary damage → hemorrhage + edema in alveoli & interstitium
            • Lung laceration: Chest trauma (blunt or penetrating) → frank tear of lung parenchyma

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • Ultrasonographic Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Carson D et al: Core curriculum illustration: pulmonary laceration. Emerg Radiol. 27(2):219-20, 2020
                                    2. Holl EM et al: Use of chest computed tomography for blunt pediatric chest trauma: does it change clinical course? Pediatr Emerg Care. 36(2):81-6, 2020
                                    3. de Roulet A et al: Pediatric trauma-associated acute respiratory distress syndrome: incidence, risk factors, and outcomes. J Pediatr Surg. 54(7):1405-10, 2019
                                    4. Rendeki S et al: Pulmonary contusion. J Thorac Dis. 11(Suppl 2):S141-51, 2019
                                    5. Weerdenburg KD et al: Predicting thoracic injury in children with multitrauma. Pediatr Emerg Care. 35(5):330-4, 2019
                                    6. Dennis BM et al: Thoracic trauma. Surg Clin North Am. 97(5):1047-64, 2017
                                    7. McNamara C et al: Predictors of intrathoracic injury after blunt torso trauma in children presenting to an emergency department as trauma activations. J Emerg Med. 52(6):793-800, 2017
                                    8. Piccolo CL et al: Diagnostic Imaging in pediatric thoracic trauma. Radiol Med. 122(11):850-65, 2017
                                    9. Holscher CM et al: Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. J Surg Res. 184(1):352-7, 2013
                                    10. Tovar JA et al: Management of chest trauma in children. Paediatr Respir Rev. 14(2):86-91, 2013
                                    11. Donnelly LF: Imaging issues in CT of blunt trauma to the chest and abdomen. Pediatr Radiol. 39 Suppl 3:406-13, 2009
                                    12. Moore MA et al: The imaging of paediatric thoracic trauma. Pediatr Radiol. 39(5):485-96, 2009
                                    13. Wylie J et al: Lung contusion in children--early computed tomography versus radiography. Pediatr Crit Care Med. 10(6):643-7, 2009
                                    14. Tovar JA: The lung and pediatric trauma. Semin Pediatr Surg. 17(1):53-9, 2008
                                    15. Kwon A et al: Isolated computed tomography diagnosis of pulmonary contusion does not correlate with increased morbidity. J Pediatr Surg. 41(1):78-82; discussion 78-82, 2006
                                    16. Roaten JB et al: Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center. J Pediatr Surg. 41(12):2013-5, 2006
                                    17. Soldati G et al: Chest ultrasonography in lung contusion. Chest. 130(2):533-8, 2006
                                    18. Sartorelli KH et al: The diagnosis and management of children with blunt injury of the chest. Semin Pediatr Surg. 13(2):98-105, 2004
                                    19. Hall A et al: The imaging of paediatric thoracic trauma. Paediatr Respir Rev. 3(3):241-7, 2002
                                    20. Donnelly LF et al: Subpleural sparing: a CT finding of lung contusion in children. Radiology. 204(2):385-7, 1997
                                    21. Karaaslan T et al: Traumatic chest lesions in patients with severe head trauma: a comparative study with computed tomography and conventional chest roentgenograms. J Trauma. 39(6):1081-6, 1995
                                    22. Moore EE et al: Organ injury scaling. IV: thoracic vascular, lung, cardiac, and diaphragm. J Trauma. 36(3):299-300, 1994
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Lung contusion: Blunt chest trauma → alveolar capillary damage → hemorrhage + edema in alveoli & interstitium
                                              • Lung laceration: Chest trauma (blunt or penetrating) → frank tear of lung parenchyma

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • Ultrasonographic Findings

                                                    • Nuclear Medicine Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Carson D et al: Core curriculum illustration: pulmonary laceration. Emerg Radiol. 27(2):219-20, 2020
                                                                      2. Holl EM et al: Use of chest computed tomography for blunt pediatric chest trauma: does it change clinical course? Pediatr Emerg Care. 36(2):81-6, 2020
                                                                      3. de Roulet A et al: Pediatric trauma-associated acute respiratory distress syndrome: incidence, risk factors, and outcomes. J Pediatr Surg. 54(7):1405-10, 2019
                                                                      4. Rendeki S et al: Pulmonary contusion. J Thorac Dis. 11(Suppl 2):S141-51, 2019
                                                                      5. Weerdenburg KD et al: Predicting thoracic injury in children with multitrauma. Pediatr Emerg Care. 35(5):330-4, 2019
                                                                      6. Dennis BM et al: Thoracic trauma. Surg Clin North Am. 97(5):1047-64, 2017
                                                                      7. McNamara C et al: Predictors of intrathoracic injury after blunt torso trauma in children presenting to an emergency department as trauma activations. J Emerg Med. 52(6):793-800, 2017
                                                                      8. Piccolo CL et al: Diagnostic Imaging in pediatric thoracic trauma. Radiol Med. 122(11):850-65, 2017
                                                                      9. Holscher CM et al: Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. J Surg Res. 184(1):352-7, 2013
                                                                      10. Tovar JA et al: Management of chest trauma in children. Paediatr Respir Rev. 14(2):86-91, 2013
                                                                      11. Donnelly LF: Imaging issues in CT of blunt trauma to the chest and abdomen. Pediatr Radiol. 39 Suppl 3:406-13, 2009
                                                                      12. Moore MA et al: The imaging of paediatric thoracic trauma. Pediatr Radiol. 39(5):485-96, 2009
                                                                      13. Wylie J et al: Lung contusion in children--early computed tomography versus radiography. Pediatr Crit Care Med. 10(6):643-7, 2009
                                                                      14. Tovar JA: The lung and pediatric trauma. Semin Pediatr Surg. 17(1):53-9, 2008
                                                                      15. Kwon A et al: Isolated computed tomography diagnosis of pulmonary contusion does not correlate with increased morbidity. J Pediatr Surg. 41(1):78-82; discussion 78-82, 2006
                                                                      16. Roaten JB et al: Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center. J Pediatr Surg. 41(12):2013-5, 2006
                                                                      17. Soldati G et al: Chest ultrasonography in lung contusion. Chest. 130(2):533-8, 2006
                                                                      18. Sartorelli KH et al: The diagnosis and management of children with blunt injury of the chest. Semin Pediatr Surg. 13(2):98-105, 2004
                                                                      19. Hall A et al: The imaging of paediatric thoracic trauma. Paediatr Respir Rev. 3(3):241-7, 2002
                                                                      20. Donnelly LF et al: Subpleural sparing: a CT finding of lung contusion in children. Radiology. 204(2):385-7, 1997
                                                                      21. Karaaslan T et al: Traumatic chest lesions in patients with severe head trauma: a comparative study with computed tomography and conventional chest roentgenograms. J Trauma. 39(6):1081-6, 1995
                                                                      22. Moore EE et al: Organ injury scaling. IV: thoracic vascular, lung, cardiac, and diaphragm. J Trauma. 36(3):299-300, 1994