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__NOTOC__
{{Pulmonary contusion}}
{{Pulmonary contusion}}
{{CMG}}
{{CMG}}
==Classification==
[[Image:Alveolus diagram.png|thumb|left|The alveoli]]


Pulmonary contusion and laceration are injuries to the lung tissue. [[Pulmonary laceration]], in which lung tissue is torn or cut, differs from pulmonary contusion in that the former involves disruption of the [[macroscopic]] architecture of the lung,<ref name="Collins07">{{cite book | author=Collins J, Stern EJ | title=Chest Radiology: The Essentials | isbn=0781763142 | publisher=Lippincott Williams & Wilkins | year= 2007 | page=120 }}</ref> while the latter does not.<ref name="Wicky00"/> When lacerations fill with blood, the result is [[pulmonary hematoma]], a collection of blood within the lung tissue.<ref name="White991">{{cite book | author=Stern EJ, White C | title=Chest Radiology Companion | publisher=Lippincott Williams & Wilkins | location=Hagerstown, MD| year=1999 | pages=103 | isbn=0-397-51732-7 }}</ref> Contusion involves hemorrhage in the [[pulmonary alveolus|alveoli]] (tiny air-filled sacs responsible for absorbing oxygen), but a [[hematoma]] is a discrete clot of blood not interspersed with lung tissue.<ref name="Moore03">{{cite book | chapter=Trauma to the chest wall and lung | author=Livingston DH, Hauser CJ | title=Trauma.  Fifth Edition | editor=Moore EE, Feliciano DV, Mattox KL | year=2003 |publisher=McGraw-Hill Professional | isbn=0071370692 | pages=525–528 }}</ref>  A collapsed lung can result when the [[pleural cavity]] (the space outside the lung) accumulates blood ([[hemothorax]]) or air ([[pneumothorax]]) or both ([[hemopneumothorax]]). These conditions do not inherently involve damage to the lung tissue itself, but they may be associated with it.  Injuries to the chest wall are also distinct from but may be associated with lung injuries. Chest wall injuries include [[rib fracture]]s and [[flail chest]], in which multiple ribs are broken so that a segment of the ribcage is detached from the rest of the chest wall and moves independently.
==Causes==
==Causes==
[[Image:Crushed Saturn.jpg|thumb|left|Motor vehicle accidents are the most common cause of pulmonary contusion.]]
[[Image:Crushed Saturn.jpg|thumb|left|Motor vehicle accidents are the most common cause of pulmonary contusion.]]
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{{
cite journal |author=Moloney JT, Fowler SJ, Chang W |title=Anesthetic management of thoracic trauma |journal=Current Opinion in Anaesthesiology |volume=21|issue=1 |pages=41–46 |year=2008 |month=February |pmid=18195608 |doi=10.1097/ACO.0b013e3282f2aadc }}
cite journal |author=Moloney JT, Fowler SJ, Chang W |title=Anesthetic management of thoracic trauma |journal=Current Opinion in Anaesthesiology |volume=21|issue=1 |pages=41–46 |year=2008 |month=February |pmid=18195608 |doi=10.1097/ACO.0b013e3282f2aadc }}
</ref> is usually caused by the rapid deceleration that results when the moving chest strikes a fixed object.<ref name="Yamamoto05"/> About 70% of cases result from motor vehicle collisions,<ref name="ullman03"/> most often when the chest strikes the inside of the car.<ref name="mlr07"/>  Falls,<ref name="ullman03">
</ref> is usually caused by the rapid deceleration that results when the moving chest strikes a fixed object. About 70% of cases result from motor vehicle collisions,<ref name="ullman03"/> most often when the chest strikes the inside of the car. Falls,<ref name="ullman03">
{{
{{
cite journal |author=Ullman EA, Donley LP, Brady WJ |title=Pulmonary trauma emergency department evaluation and management |journal=Emergency Medicine Clinics of North America |volume=21 |issue=2 |pages=291–313 |year=2003 |pmid=12793615 |doi=10.1016/S0733-8627(03)00016-6 }}
cite journal |author=Ullman EA, Donley LP, Brady WJ |title=Pulmonary trauma emergency department evaluation and management |journal=Emergency Medicine Clinics of North America |volume=21 |issue=2 |pages=291–313 |year=2003 |pmid=12793615 |doi=10.1016/S0733-8627(03)00016-6 }}
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</ref> and sports injuries are other causes.<ref name="France03">
</ref> and sports injuries are other causes.<ref name="France03">
{{
{{
cite book |title=Introduction to Sports Medicine and Athletic Training |chapter= The chest and abdomen |author=France R| year=2003 |publisher = Thomson Delmar Learning |page=506–507 |isbn=140181199X}}</ref>  Pulmonary contusion can also be caused by explosions; the organs most vulnerable to [[blast injury|blast injuries]] are those that contain gas, such as the lungs.<ref name="CohnSM"/>  Blast lung is severe pulmonary contusion, bleeding, or [[edema]]with damage to alveoli and blood vessels, or a combination of these.<ref name="Sasser06">
cite book |title=Introduction to Sports Medicine and Athletic Training |chapter= The chest and abdomen |author=France R| year=2003 |publisher = Thomson Delmar Learning |page=506–507 |isbn=140181199X}}</ref>  Pulmonary contusion can also be caused by explosions; the organs most vulnerable to [[blast injury|blast injuries]] are those that contain gas, such as the lungs. Blast lung is severe pulmonary contusion, bleeding, or [[edema]] with damage to alveoli and blood vessels, or a combination of these.<ref name="Sasser06">
{{
{{
cite journal |author=Sasser SM, Sattin RW, Hunt RC, Krohmer J |title=Blast lung injury |journal=Prehospital Emergency Care |volume=10 |issue=2 |pages=165–72|year=2006 |pmid=16531371 |doi=10.1080/10903120500540912 }}</ref> This is the primary cause of death among people who initially survive an explosion.<ref name="Born05">
cite journal |author=Sasser SM, Sattin RW, Hunt RC, Krohmer J |title=Blast lung injury |journal=Prehospital Emergency Care |volume=10 |issue=2 |pages=165–72|year=2006 |pmid=16531371 |doi=10.1080/10903120500540912 }}</ref> This is the primary cause of death among people who initially survive an explosion.<ref name="Born05">
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cite book |author= Lucid WA, Taylor TB |chapter=Thoracic trauma| editor=Strange GR |title=Pediatric Emergency Medicine: A Comprehensive Study Guide|publisher=McGraw-Hill, Medical Publishing Division |location=New York |year=2002 |pages=92–100 |isbn=0-07-136979-1  
cite book |author= Lucid WA, Taylor TB |chapter=Thoracic trauma| editor=Strange GR |title=Pediatric Emergency Medicine: A Comprehensive Study Guide|publisher=McGraw-Hill, Medical Publishing Division |location=New York |year=2002 |pages=92–100 |isbn=0-07-136979-1  
}}
}}
</ref>  Contusion resulting from penetration by a rapidly moving projectile usually surrounds the path along which the projectile traveled through the tissue.<ref name="Karmy02">{{cite book | chapter=Pulmonary contusion | author=Sattler S, Maier RV | editor=Karmy-Jones R, Nathens A, Stern EJ |title=Thoracic Trauma and Critical Care | publisher=Springer | location=Berlin | year=2002 | pages=159–160 and 235–243 | isbn=1-4020-7215-5}}</ref> The pressure wave forces tissue out of the way, creating a temporary [[cavitation|cavity]]; the tissue quickly moves back into place, but it is damaged.  Pulmonary contusions that accompany gun and knife wounds are not usually severe enough to have a major effect on outcome;<ref name="White99"/>  penetrating trauma causes less widespread lung damage than does blunt trauma.<ref name="ullman03"/> An exception is shotgun wounds, which can seriously damage large areas of lung tissue through a blast injury mechanism.<ref name="White99"/>
</ref>  Contusions resulting from penetration by a rapidly moving projectile usually surrounds the path along which the projectile traveled through the tissue.<ref name="Karmy02">{{cite book | chapter=Pulmonary contusion | author=Sattler S, Maier RV | editor=Karmy-Jones R, Nathens A, Stern EJ |title=Thoracic Trauma and Critical Care | publisher=Springer | location=Berlin | year=2002 | pages=159–160 and 235–243 | isbn=1-4020-7215-5}}</ref> The pressure wave forces tissue out of the way, creating a temporary [[cavitation|cavity]]; the tissue quickly moves back into place, but it is damaged.  Pulmonary contusions that accompany gun and knife wounds are not usually severe enough to have a major effect on outcome; penetrating trauma causes less widespread lung damage than does blunt trauma.<ref name="ullman03"/> An exception is shotgun wounds, which can seriously damage large areas of lung tissue through a blast injury mechanism.
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Needs overview]]


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Latest revision as of 15:27, 5 April 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

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

Pulmonary contusion, which occurs in 25–35% of all blunt chest trauma,[1] is usually caused by the rapid deceleration that results when the moving chest strikes a fixed object. About 70% of cases result from motor vehicle collisions,[2] most often when the chest strikes the inside of the car. Falls,[2] assaults,[3] and sports injuries are other causes.[4] Pulmonary contusion can also be caused by explosions; the organs most vulnerable to blast injuries are those that contain gas, such as the lungs. Blast lung is severe pulmonary contusion, bleeding, or edema with damage to alveoli and blood vessels, or a combination of these.[5] This is the primary cause of death among people who initially survive an explosion.[6]

In addition to blunt trauma, penetrating trauma can cause pulmonary contusion.[7] Contusions resulting from penetration by a rapidly moving projectile usually surrounds the path along which the projectile traveled through the tissue.[8] The pressure wave forces tissue out of the way, creating a temporary cavity; the tissue quickly moves back into place, but it is damaged. Pulmonary contusions that accompany gun and knife wounds are not usually severe enough to have a major effect on outcome; penetrating trauma causes less widespread lung damage than does blunt trauma.[2] An exception is shotgun wounds, which can seriously damage large areas of lung tissue through a blast injury mechanism.

References

  1. Moloney JT, Fowler SJ, Chang W (2008). "Anesthetic management of thoracic trauma". Current Opinion in Anaesthesiology. 21 (1): 41–46. doi:10.1097/ACO.0b013e3282f2aadc. PMID 18195608. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 2.2 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.
  3. 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.
  4. France R (2003). "The chest and abdomen". Introduction to Sports Medicine and Athletic Training. Thomson Delmar Learning. p. 506–507. ISBN 140181199X.
  5. 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.
  6. Born CT (2005). "Blast trauma: The fourth weapon of mass destruction" (PDF). Scandanavian Journal of Surgery. 94 (4): 279–285. PMID 16425623.
  7. Lucid WA, Taylor TB (2002). "Thoracic trauma". In Strange GR. Pediatric Emergency Medicine: A Comprehensive Study Guide. New York: McGraw-Hill, Medical Publishing Division. pp. 92–100. ISBN 0-07-136979-1.
  8. Sattler S, Maier RV (2002). "Pulmonary contusion". In Karmy-Jones R, Nathens A, Stern EJ. Thoracic Trauma and Critical Care. Berlin: Springer. pp. 159–160 and 235–243. ISBN 1-4020-7215-5.

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