Pulmonary laceration overview: Difference between revisions
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==Overview== | ==Overview== | ||
A '''pulmonary laceration''' is a chest injury in which [[lung]] tissue is torn or cut.<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=161-163|isbn=1-4020-7215-5 |oclc= |doi= |accessdate=2008-05-05 |url=http://books.google.com/books?id=zSge9BxBCd0C&pg=PA235&dq=%22pulmonary+contusion%22&lr=&sig=uGqtmdp1-4Rg6zbN2W3gTE_aszU#PPA235,M1 | |||
}} </ref> An injury that is potentially more serious than [[pulmonary contusion]], pulmonary [[laceration]] involves disruption of the 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 | url=http://books.google.com/books?id=LCeOBrXIY1sC&pg=PA120&dq=pulmonary+contusion&lr=&client=firefox-a&sig=qv_leqFHepNlE9nWnC8rmzQede8 |accessdate=2008-04-26 |page=120 | |||
}}</ref> | |||
==Causes== | |||
Pulmonary laceration is a common result of [[penetrating trauma]] but may also be caused by [[blunt trauma]]; [[rib fracture|broken ribs]] may perforate the lung, or the tissue may be torn due to [[Shear stress |shearing force]]s<ref name="Matthay05"> | |||
{{cite book |author=| chapter=Thoracic trauma, surgery, and perioperative management |editor=Matthay RA, George RB, Light RJ, Matthay MA |title=Chest Medicine: Essentials of Pulmonary and Critical Care Medicine |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2005 |pages=580 |isbn=0-7817-5273-6 |oclc= |doi= |accessdate= 2008-04-21 |url= http://books.google.com/books?id=ZzlX2zJMbdgC&pg=RA1-PA587&dq=%22pulmonary+contusion%22&lr=&sig=n6DLtwZBenAAwCpYUaKSczmeU6c#PRA1-PA578,M1 | |||
}}</ref> that result from different rates of acceleration or deceleration of different tissues of the lung. Pulmonary laceration may result from blunt and penetrating forces that occur in the same injury and may be associated with pulmonary contusion.<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 |url=}}</ref><ref name="mlr07">{{cite journal |author=Miller DL, Mansour KA |title=Blunt traumatic lung injuries |journal=Thoracic Surgery Clinics |volume=17 |issue=1 |pages=57–61 |year=2007 |pmid=17650697 |doi= 0.1016/j.thorsurg.2007.03.017 | |||
}} | |||
</ref> As with contusions, pulmonary lacerations usually occur near solid structures in the chest such as [[rib]]s. Pulmonary laceration is suspected when rib fractures are present. | |||
==Diagnosis== | |||
===CT=== | |||
[[CT scan]]ning is more sensitive and better at detecting pulmonary laceration than [[X-ray]]s are,<ref name="Costantino06"> | |||
{{cite journal |author=Costantino M, Gosselin MV, Primack SL |title=The ABC's of thoracic trauma imaging |journal=Seminars in Roentgenology |volume=41 |issue=3 |pages=209–225 |year=2006 |month=July |pmid=16849051 |doi=10.1053/j.ro.2006.05.005 |url= | |||
}}</ref> and often reveals multiple lacerations in cases where chest X-ray showed only a contusion. Before CT scanning was widely available, pulmonary laceration was considered unusual because it was not common to find with [[X-ray]] alone. On a CT scan, pulmonary lacerations show up in a contused area of the lung,<ref name="Hopkins08">{{cite book |author=Hopkins RL, Peden C, Ghandi S |chapter=Trauma radiology |title=Radiology for Anaesthesia and Intensive Care |publisher=Cambridge University Press |location=Cambridge, UK |year=2008 |pages=135 |isbn=0-521-69485-X |oclc= |doi= |accessdate= |url=http://books.google.com/books?id=9UDvpaw8d6YC&pg=PA133&dq=pulmonary+laceration&lr=&client=firefox-a&sig=DGLYopNn5ICNDT7nad_RdWxdrQg#PPA135,M1 | |||
}}</ref> typically appearing as cavities filled with air or fluid<ref name="Strife02"> | |||
{{cite book |author=Donnelly LF |chapter=CT of Acute pulmonary infection/trauma |editor=Strife JL, Lucaya J |title=Pediatric Chest Imaging: Chest Imaging in Infants and Children |publisher=Springer |location=Berlin |year=2002 |pages= 123 |isbn=3-540-43557-3 |oclc= |doi= |accessdate= 2008-05-01 |url=http://books.google.com/books?id=o5FLRDJsOFgC&pg=PA124&dq=pulmonary+laceration&lr=&client=firefox-a&sig=2nK66fOXCjEiEMc3N7I8O83DcJE}}</ref> that usually have an elliptical or ovoid shape. The roundness of the cavity is due to the elasticity of the lung. | |||
===Other Diagnostic Studies=== | |||
Pulmonary laceration is usually accompanied by [[hemoptysis]] (coughing up blood or of blood-stained sputum).<ref name="Gavelli02"> | |||
{{cite journal |author=Gavelli G, Canini R, Bertaccini P, Battista G, Bnà C, Fattori R |title=Traumatic injuries: imaging of thoracic injuries |journal=European Radiology |volume=12 |issue=6 |pages=1273–1294 |year=2002 |month=June |pmid=12042932 |doi=10.1007/s00330-002-1439-6 |url= | |||
}}</ref>[[Tracheobronchial]] injury can be ruled out using [[bronchoscopy]]. [[Thoracoscopy]] may be used in both diagnosis and treatment of pulmonary laceration. | |||
==References== | ==References== | ||
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[[Category:Chest trauma]] | [[Category:Chest trauma]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Disease]] | |||
Latest revision as of 19:59, 20 February 2013
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Pulmonary laceration overview On the Web |
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American Roentgen Ray Society Images of Pulmonary laceration overview |
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Risk calculators and risk factors for Pulmonary laceration overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A pulmonary laceration is a chest injury in which lung tissue is torn or cut.[1] An injury that is potentially more serious than pulmonary contusion, pulmonary laceration involves disruption of the architecture of the lung.[2]
Causes
Pulmonary laceration is a common result of penetrating trauma but may also be caused by blunt trauma; broken ribs may perforate the lung, or the tissue may be torn due to shearing forces[3] that result from different rates of acceleration or deceleration of different tissues of the lung. Pulmonary laceration may result from blunt and penetrating forces that occur in the same injury and may be associated with pulmonary contusion.[4][5] As with contusions, pulmonary lacerations usually occur near solid structures in the chest such as ribs. Pulmonary laceration is suspected when rib fractures are present.
Diagnosis
CT
CT scanning is more sensitive and better at detecting pulmonary laceration than X-rays are,[6] and often reveals multiple lacerations in cases where chest X-ray showed only a contusion. Before CT scanning was widely available, pulmonary laceration was considered unusual because it was not common to find with X-ray alone. On a CT scan, pulmonary lacerations show up in a contused area of the lung,[7] typically appearing as cavities filled with air or fluid[8] that usually have an elliptical or ovoid shape. The roundness of the cavity is due to the elasticity of the lung.
Other Diagnostic Studies
Pulmonary laceration is usually accompanied by hemoptysis (coughing up blood or of blood-stained sputum).[9]Tracheobronchial injury can be ruled out using bronchoscopy. Thoracoscopy may be used in both diagnosis and treatment of pulmonary laceration.
References
- ↑ Sattler S, Maier RV (2002). "Pulmonary contusion". In Karmy-Jones R, Nathens A, Stern EJ. Thoracic Trauma and Critical Care. Berlin: Springer. pp. 161–163. ISBN 1-4020-7215-5. Retrieved 2008-05-05.
- ↑ Collins J, Stern EJ (2007). Chest Radiology: The Essentials. Lippincott Williams & Wilkins. p. 120. ISBN 0781763142. Retrieved 2008-04-26.
- ↑ Matthay RA, George RB, Light RJ, Matthay MA, ed. (2005). "Thoracic trauma, surgery, and perioperative management". Chest Medicine: Essentials of Pulmonary and Critical Care Medicine. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 580. ISBN 0-7817-5273-6. Retrieved 2008-04-21.
- ↑ 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.
- ↑ Miller DL, Mansour KA (2007). "Blunt traumatic lung injuries". Thoracic Surgery Clinics. 17 (1): 57–61. doi:0.1016/j.thorsurg.2007.03.017 Check
|doi=value (help). PMID 17650697. - ↑
Costantino M, Gosselin MV, Primack SL (2006). "The ABC's of thoracic trauma imaging". Seminars in Roentgenology. 41 (3): 209–225. doi:10.1053/j.ro.2006.05.005. PMID 16849051. Unknown parameter
|month=ignored (help) - ↑ Hopkins RL, Peden C, Ghandi S (2008). "Trauma radiology". Radiology for Anaesthesia and Intensive Care. Cambridge, UK: Cambridge University Press. p. 135. ISBN 0-521-69485-X.
- ↑ Donnelly LF (2002). "CT of Acute pulmonary infection/trauma". In Strife JL, Lucaya J. Pediatric Chest Imaging: Chest Imaging in Infants and Children. Berlin: Springer. p. 123. ISBN 3-540-43557-3. Retrieved 2008-05-01.
- ↑
Gavelli G, Canini R, Bertaccini P, Battista G, Bnà C, Fattori R (2002). "Traumatic injuries: imaging of thoracic injuries". European Radiology. 12 (6): 1273–1294. doi:10.1007/s00330-002-1439-6. PMID 12042932. Unknown parameter
|month=ignored (help)