| Pulmonary contusion | |
|---|---|
| Other names | Lung contusion |
 | |
| ACT scan showing a pulmonary contusion (red arrow) accompanied by a rib fracture (blue arrow) | |
| Specialty | Emergency medicine |
| Symptoms | Shortness of breath, coughing[1] |
| Complications | Acute respiratory distress syndrome, pneumonia, pulmonary bleeding, respiratory failure[1] |
| Usual onset | Hours to days[1] |
| Duration | 5 to 7 days[1] |
| Causes | Blunt chest trauma, explosions, penetrating injuries[1] |
| Diagnostic method | Medical imaging[1] |
| Differential diagnosis | Hemothorax, pulmonary edema including transfusion-associated lung injury[1] |
| Treatment | Supportive care[1] |
| Frequency | Common[2] |
Apulmonary contusion, also known as lung contusion, is a bruise of the lung.[1] Symptoms may include shortness of breath, chest wall tenderness, and coughing, including coughing up blood.[1][2] Onset of symptoms may occur within hours to days of the injury.[1] Complications can include acute respiratory distress syndrome, pneumonia, pulmonary bleeding, and respiratory failure.[1] Unlike lung laceration, pulmonary contusion does not involve a cut or tear of the lung tissue.[1]
It is usually caused by blunt trauma to the chest.[1] Other causes include the shock wave from an explosion or penetrating injury.[1] The underlying mechanism involves injury to the lung parenchyma, leading to leakage of fluid from the capillaries into the alveoli.[1] Diagnosis is by medical imaging such as chest X-ray, CT scan, or ultrasound.[1] Associated injuries may include rib fractures or a pneumothorax.[2]
The use of seat belts and airbags reduces the risk to people in vehicles.[3] The contusion frequently heals on its own with supportive care.[1] This may include close monitoring, supplemental oxygen, and pain medication.[1][2] If breathing is severely compromised, mechanical ventilation may be necessary.[2] Fluid replacement may be required to ensure adequate blood volume, but fluids are given carefully since fluid overload can worsen pulmonary edema.[1]
Pulmonary contusions are common, making up about 30% to 75% of lung injuries due to blunt chest injuries.[2][1] The risk of death is about 10% to 25%.[1] The condition was first described in 1761 by the Italian Morgagni.[1] With the use of explosives during World Wars I and II, pulmonary contusion from blasts gained greater recognition.[1]
