Traumatic hematoma, Traumatic Lung Cyst, Traumatic Pneumatocoele 

 

·         Most thoracic trauma is due to motor vehicle accidents

·         Most thoracic trauma is blunt, rather than penetrating

·         Lacerations usually result from blunt chest trauma

·         Lacerations are tears in the lung parenchyma

·         They tend to occur more often in children and young adults

·         Imaging Findings

o       Usually not apparent at first because of surrounding pulmonary contusion

§         Contusions characteristically clear rapidly, sometimes within 48 hours

o       On CT, they will present as cystic lucencies, frequently beneath a rib fracture

§         CT is more sensitive than conventional radiographs for detecting a pulmonary laceration

 

Pulmonary laceration. CT of the chest demonstrates a partially-cystic,
partially fluid-filled structure in the left lower lobe (red arrow) near a rib fracture (black arrow)
in this patient who was an unrestrained passenger in a motor vehicle collision. The blue arrow
points to an area of subpleural hemorrhage representing a pulmonary contusion
For a photo of the same image without arrows, click here

 

o       Half are solid, mass-like lesions (pulmonary hematoma)

o       Half are thin-walled cystic structures (traumatic lung cyst) with or without air-fluid level — depends on how much bleeding into laceration

o       Usually subpleural location under point of maximum impact

o       May be single or multiple

·         Characteristically, they take a long time to heal – weeks to months

o       Gradually decrease in size.

·         No symptoms from laceration itself unless it becomes infected, which is rare