Clinical History
14 year old male, with blunt thorax trauma after falling down from a tree.
Discussion
A laceration is defined as an abnormal intraparenchymal collection of air resulting from traumatic disruption of the lung architecture. Types of laceration: Type 1 is an air-filled cavity with or
without an air-fluid level, resulting from sudden compression of a pliable chest wall wherein the air-containing lung ruptures. Type 2 is an air-containing cavity in a paravertebral
location,resulting from severe compression of the more pliable lower chest wall and sudden shifting of the lower lobe across the vertebral body causing a shearing type of injury. Type 3 is a small
peripheral cavity or peripheral linear radiolucency that is always close to the chest wall where a rib has been fractured, resulting from a fractured rib that has punctured the lung. Type 4 is a
result of previously formed, firm pleuropulmonary adhesions causing the lung to tear when the overlying chest wall is violently moved inward or fractures, diagnosed only at surgery or autopsy. The
intraparenchymal collections of air described are also termed pneumatoceles. When traumatic cavities fill with blood, a hematoma forms. Radiographically, traumatic pneumatoceles and hematomas are not
usually seen until a few hours or even several days after trauma, initially obscured by surrounding contusion. The size, shape, thickness of the wall, and number of pneumatoceles varies widely from
patient to patient. Unlike simple contusion, which resolves fairly quickly and completely, a laceration generally takes weeks to months to resolve and may result in residual scarring. Occasionally,
pneumatoceles can become secondarily infected, resembling formation of a hematoma.
Differential Diagnosis List
TRAUMATIC PNEUMATOCELE TYPE I
Final Diagnosis
TRAUMATIC PNEUMATOCELE TYPE I