Fact-sheet: Pulmonary contusion


Updated on 09/20/2019 at 10:30 AM

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Definition

Areas of alveolar and interstitial hemorrhage with preservation of alveolar architecture

Most common pulmonary traumatic lesion

Injury mechanisms:

  • Direct impact (at the point of impact and contralaterally)
  • Compression or crushing

Clinical features

Asymptomatic

Dyspnea

Rarely the cause of hemoptysis

CT

Ground-glass opacities / consolidation foci, more or less extensive:

  • Non-segmental (not limited by fissures)
  • Rather peripheral
  • Occasional sparing of the subpleural space due to low vascularity (inconsistent)

Time course:

  • Present from the time of trauma (<6h)
  • Worsening within the first 24-48 hours
  • Resolution within 5 to 7 days if limited in extent
  • Possible progression to ARDS if extensive

Differential diagnosis

Aspiration pneumonia: involvement of the subpleural space