Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Case 30 Pseudopneumomediastinum
- Case 31 Traumatic pneumomediastinum without aerodigestive injury
- Case 32 Pseudopneumothorax
- Case 33 Subcutaneous emphysema and mimickers
- Case 34 Tracheal injury
- Case 35 Pulmonary contusion and laceration
- Case 36 Sternoclavicular dislocation
- Case 37 Boerhaave syndrome
- Case 38 Variants and hernias of the diaphragm simulating injury
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 35 - Pulmonary contusion and laceration
from Section 3 - Thorax
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Case 30 Pseudopneumomediastinum
- Case 31 Traumatic pneumomediastinum without aerodigestive injury
- Case 32 Pseudopneumothorax
- Case 33 Subcutaneous emphysema and mimickers
- Case 34 Tracheal injury
- Case 35 Pulmonary contusion and laceration
- Case 36 Sternoclavicular dislocation
- Case 37 Boerhaave syndrome
- Case 38 Variants and hernias of the diaphragm simulating injury
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
Pulmonary contusions, aspiration, and pneumonia have overlapping imaging appearances, and can be difficult to distinguish in the acutely injured patient. However, both the imaging and appearance and time course can assist in discriminating between these entities. On radiographs, contusions appear as geographic areas of air-space opacification, and are usually located adjacent to bony structures and hence are peripherally located [1].
Pulmonary contusions may not be evident on initial radiographs but may appear on chest radiographs acquired up to 6 hours after injury. Development of pulmonary opacities 24 hours or more after injury suggests nosocomial pneumonia, atelectasis, or aspiration. However, caution is still warranted. Series have shown that the appearance of a pulmonary opacity has a specificity of only 27–35% for pneumonia in a patient on mechanical ventilation [2]. Specific signs that suggest ventilator-associated pneumonia (VAP) include rapid or progressive cavitation of the pulmonary opacity, an airspace process abutting a fissure, and an air bronchogram [2].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 118 - 120Publisher: Cambridge University PressPrint publication year: 2013