Pulmonary Laceration


Background
  1. Trauma to the lung parenchyma
  2. Usually results from
  3. Usually NOT a life threatening injury

Pathophysiology

  1. Lung parenchyma is torn / cut by implement
  2. Parenchyma bleeds into chest cavity and alveolar space
  3. Most bleeding eventually tamponades spontaneously
  4. Bleeding can continue if:
  5. Associated injuries

Diagnostics

  1. History / symptoms
  2. Physical findings
  3. Diagnostic testing
  4. Diagnostic imaging

Differential Diagnosis

  1. Pneumothorax
  2. Tension Pneumothorax
  3. Hemothorax
  4. Massive Hemothorax
  5. Tracheal / Bronchial Injuries
  6. Non-aortic Vascular Trauma
  7. Traumatic Aortic Rupture

Treatment

  1. ATLS primary survey
  2. Initial management is tube thoracostomy
  3. If bleeding continues
  4. Tetanus prophylaxis

Disposition

  1. Admit all patients