Giant posttraumatic hemopneumatocele: nonoperative management is safe

Unusual cavitary lesions of the lung: Analysis of patients with traumatic pulmonary pseudocyst

OBJECTIVE:

In this study, we aimed to draw attention to traumatic pulmonary pseudocysts, which are rare cavitary lesions resulting from thoracic trauma, and review the diagnostic and therapeutic approaches and results.

METHODS:

Between January 2014 and January 2017, 30 patients included in this study who were diagnosed with traumatic pulmonary pseudocysts, from 582 patients who were admitted to our hospital with blunt thoracic trauma. To obtain data from the hospital information management system of patients included in this study, permission was obtained from the medical specialization board and the data were analyzed retrospectively.

RESULTS:

The mean age of the patients with traumatic pulmonary pseudocysts was 40.8 years (range, 7–75 years), and 11 (36.7%) of the patients were under the age of thirty and 19 (63.3%) were over the age of thirty. Twenty-eight (93.3%) patients had lung contusion and among those who had traumatic pulmonary pseudocysts diameter less than 2 cm, in 10 (33.3%) patients, contusion was present. In 27 patients, TPP was seen in thoracic computed tomography and diagnosed in the first 12 hours, but only in 10 of these patients, traumatic pulmonary pseudocysts was seen on chest x-ray. The extrathoracic injury was found in 15 (50%) patients. Twenty-two (73.3%) patients underwent tube thoracostomy. No patient required a thoracotomy.

CONCLUSION:

Traumatic pneumatoceles are benign lesions and most of them regress with symptomatic treatment and supportive therapy without any specific treatment.

Traumatic pulmonary pseudocyst: An underreported entity

BACKGROUND

Traumatic pulmonary pseudocysts (TPP) are underreported cavitary lesions of the pulmonary parenchyma that can develop following blunt chest trauma. Although the occurrence of traumatic pulmonary pseudocyst is rare, this condition should be considered in the differential diagnosis of any cavitary lesion. Awareness of this injury and its clinical significance is important for successful management in order to avoid medical errors in the course of treatment.

METHODS

A literature search was conducted through Medline using the key phrases "traumatic pulmonary pseudocyst" and "traumatic pneumatocele." Relevant articles, especially those with focus on diagnosis and management of traumatic pneumatocele in adults, were selected. Due to the scarcity of literature and lack of Level I evidence on this subject, studies published in any year were considered.

RESULTS

A search of "traumatic pulmonary pseudocyst" and "traumatic pneumatocele" yielded 114 studies. Most of these were excluded based on inclusion and exclusion criteria. Thirty-five articles were reviewed. The majority of these were individual case studies; only eight articles were considered large case studies (greater than eight patients).

CONCLUSION

Traumatic pulmonary pseudocysts are lesions that occur secondary to blunt chest trauma. Diagnosis is based on a history of trauma and appearance of a cystic lesion on CT. Accurate diagnosis of traumatic pulmonary pseudocyst is imperative to achieve successful outcomes. Failure to do so may lead to unnecessary procedures and complications.

An unusual case of traumatic pneumatocele in a nine-year-old girl: a bronchial tear with clear bronchial laceration

Post-traumatic pneumatoceles (traumatic pulmonary pseudocysts) after blunt thoracic trauma are not frequently observed. It is widely accepted that pneumatoceles are caused by compression of the lung resulting in bursting parenchyma, followed by decompression of the chest with negative intrathoracic pressure. We present a case of post-traumatic pneumatocele in a nine-year-old girl who was crushed under the tailboard of a horse hamper. A multislice CT of the thorax clearly demonstrated a bronchial laceration pointing to bronchial disruption as an additional causative mechanism.