Pulmonary contusion

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

A pulmonary contusion (or lung contusion) is a contusion (bruise) of the lung, caused by chest trauma. The bruise harms the capillaries, and then blood and other liquids collect in the lungs. These extra liquids prevent with gas exchange. Without gas exchange, oxygen levels drop (hypoxia). If the lung is cut, then the injury is instead a pulmonary laceration and has different symptoms.

A lung contusion is usually caused by blunt trauma. Explosion injuries or a shock wave from a penetrating trauma may also cause this injury.

Doctors began studying this injury after explosives hurt soldiers in World Wars I and II. In the 1960s when cars became popular people began to get this kind of injury from car accidents. 

Classification[change | change source]

Lung contusion and laceration are injuries to the lung. In contusion, the structure of the lung does not change. In laceration, the pieces of lung may be moved.[1][2] When blood fills lacerations, the injury is called pulmonary hematoma.[3] The difference between a contusion and a hematoma is that in a contusion, the alveoli (tiny air-filled sacs that give oxygen) will bleed, but a hematoma is a blood clot.[4]

If the pleural cavity (the space outside the lung) accumulates blood (hemothorax) or air (pneumothorax) or both (hemopneumothorax) then this is called a collapsed lung. These conditions do not always damage the lung but they might, or they might be the result of damage. Injuries to the chest wall are also distinct from but may happen with lung injuries. Chest wall injuries include rib fractures and flail chest. In flail chest multiple ribs are broken move independently of the rib cage.

Causes[change | change source]

Motor vehicle accidents are the most common cause of pulmonary contusion.

Pulmonary contusion is the most common injury found in blunt chest trauma,[5] occurring in 25–35% of cases.[6] It is usually caused by a collision while moving quickly.[7] About 70% of cases result from motor vehicle collisions,[8] most often when the chest strikes the inside of the car.[9] Falls,[8] assaults,[10] and sports injuries are other causes.[11] Pulmonary contusion can also be caused by explosions. The organs most harmed by blast injuries are those that hold gas, such as the lungs.[12] Blast lung is severe pulmonary contusion, bleeding, or edema with damage to alveoli and blood vessels, or a combination of these.[13] This is the usual cause of death among people who initially survive an explosion.[14] Unlike other causes of injury in which pulmonary contusion is often found with other injuries, explosions can cause pulmonary contusion without damage to the chest wall.[5]

References[change | change source]

  1. Collins J, Stern EJ (2007). Chest Radiology: The Essentials. Lippincott Williams & Wilkins. p. 120. ISBN 0-7817-6314-2.
  2. Wicky S, Wintermark M, Schnyder P, Capasso P, Denys A (2000). "Imaging of blunt chest trauma". European Radiology 10 (10): 1524–1538. doi:10.1007/s003300000435. PMID 11044920. 
  3. Stern EJ, White C (1999). Chest Radiology Companion. Hagerstown, MD: Lippincott Williams & Wilkins. p. 103. ISBN 0-397-51732-7.
  4. Livingston DH, Hauser CJ (2003). "Trauma to the chest wall and lung". In Moore EE, Feliciano DV, Mattox KL. Trauma. Fifth Edition. McGraw-Hill Professional. pp. 525–528. ISBN 0-07-137069-2.
  5. 5.0 5.1 Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1097/TA.0b013e31827019fd, please use {{cite journal}} with |doi=10.1097/TA.0b013e31827019fd instead.
  6. Moloney JT, Fowler SJ, Chang W (February 2008). "Anesthetic management of thoracic trauma". Current Opinion in Anesthesiology 21 (1): 41–46. doi:10.1097/ACO.0b013e3282f2aadc. PMID 18195608. 
  7. Yamamoto L, Schroeder C, Morley D, Beliveau C (2005). "Thoracic trauma: The deadly dozen". Critical Care Nursing Quarterly 28 (1): 22–40. doi:10.1097/00002727-200501000-00004. PMID 15732422. 
  8. 8.0 8.1 Ullman EA, Donley LP, Brady WJ (2003). "Pulmonary trauma emergency department evaluation and management". Emergency Medicine Clinics of North America 21 (2): 291–313. doi:10.1016/S0733-8627(03)00016-6. PMID 12793615. 
  9. Miller DL, Mansour KA (2007). "Blunt traumatic lung injuries". Thoracic Surgery Clinics 17 (1): 57–61. doi:10.1016/j.thorsurg.2007.03.017. PMID 17650697. 
  10. Haley K, Schenkel K (2003). "Thoracic trauma". In Thomas DO, Bernardo LM, Herman B. Core curriculum for pediatric emergency nursing. Sudbury, Mass: Jones and Bartlett Publishers. p. 446. ISBN 0-7637-0176-9.
  11. France R (2003). "The chest and abdomen". Introduction to Sports Medicine and Athletic Training. Thomson Delmar Learning. pp. 506–507. ISBN 1-4018-1199-X.
  12. Cohn SM (1997). "Pulmonary contusion: Review of the clinical entity". Journal of Trauma 42 (5): 973–979. doi:10.1097/00005373-199705000-00033. PMID 9191684. 
  13. Sasser SM, Sattin RW, Hunt RC, Krohmer J (2006). "Blast lung injury". Prehospital Emergency Care 10 (2): 165–72. doi:10.1080/10903120500540912. PMID 16531371. 
  14. Born CT (2005). "Blast trauma: The fourth weapon of mass destruction" (PDF). Scandinavian Journal of Surgery 94 (4): 279–285. PMID 16425623. http://www.fimnet.fi/sjs/articles/SJS42005-279.pdf.