Pediatric Pulmonary Laceration

  • Etiology:
    — Blunt thoracic trauma causes tear in lung parenchyma resulting in cavity that fills with blood
    — Is a result of increased alveolar pressure on a closed glottis
  • Imaging CXR: Often obscured by pulmonary contusion
  • Imaging CT: Round or oval cavity that is single or multiple and unilocular or multiloculated
    — Air containing = traumatic pneumatocele
    — Blood containing = traumatic hematocele
    — Air and blood containing = traumatic hematopneumatocele
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Heals more slowly than pulmonary contusion

Radiology Cases of Pulmonary Laceration

CXR and CT of pneumatoceles
CXR AP shows patchy airspace disease in the right lung. Axial CT with contrast of the chest shows right-sided airspace disease as well as thin-walled cysts with fluid-fluid levels.
CXR and CT of pulmonary laceration
CXR AP (above) shows extensive opacification of the right middle and lower lobes with a small cystic structure in the middle. Axial CT with contrast of the chest (below) shows a multiseptated lesion containing air and blood in the right lower lobe.