Pulmonary laceration and contusion in a young male patient due to a motorcycle accident

Abstract

Chest trauma injuries are one of the main causes of death in young people and include lung contusions, lacerations, pneumothorax, hemothorax, rib fractures and tracheobronchial injuries. Pulmonary contusions are the most common identified entities after trauma, and they result in alveolar hemorrhage without loss of the physiological structure of lung parenchyma. On the other hand, pulmonary lacerations, which are often associated with contusions, result in rupture of the alveoli causing formation of cavities. Patients present symptoms ranging from minimal to severe, including cough, chest pain, hemoptysis, dyspnea, tachypnea, and hypoxemia. Findings may not be apparent immediately after injury and chest CT is the most sensitive imaging technique for diagnosis. Contusions usually resolve with supportive care in 5–7 days. In this report, we present a case of lung contusion and laceration in a 19-year-old patient after a motorcycle accident. INTRODUCTION Chest trauma injuries are one of the main causes of death in young people and include lung contusions, lacerations, pneumothorax, hemothorax, rib fractures and tracheobronchial injuries1,2. Pulmonary contusion is the most common identified entity after trauma and usually results from blunt chest trauma (traffic accidents, falls from great heights), shock waves associated with penetrating chest injury, or explosion injuries3,4. Unlike contusion, pulmonary laceration results in disruption of the architecture of the lung and could potentially cause more serious damage. Pulmonary lacerations are commonly caused by penetrating trauma and result in formation of one or multiple cavities filled with air, blood, or both5. In this report, we present a case of lung contusion and laceration in a 19-year-old patient after a motorcycle accident. CASE PRESENTATION A 19-year-old patient, non-smoker, without previous medical history, presented to the emergency room due to fever and pain at the right periorbital area of the face after a motorcycle collision twenty-four hours ago. The patient was examined initially by general surgeons. He was febrile (38°C) and hemodynamically stable. His oxygen saturation was normal (SatO2: 98% breathing room air) and he had normal breath sounds in auscultation. From physical examination, he presented with bruise injuries in the right side of the face and a right periorbital hematoma. His laboratory examinations revealed normal hemoglobin (15.9 g/dL), elevated white blood cell count (14.90 K/μL with 78.7% neutrophils), elevated creatine kinase (956 U/L) and elevated C reactive protein (96.9 mg/L). After exclusion of SARS-Cov-2 infection, he underwent computed tomography (CT) of the head which showed fracture displacement AFFILIATION 1 2nd Pulmonary Medicine Department, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 2 Western Attica General Hospital Agia Barbara, Athens, Greece 3 Clinic of Oral & Maxillofacial Surgery, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 4 2nd Department of Anesthesiology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 5 2nd Department of Radiology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece *Contributed equally CORRESPONDENCE TO Effrosyni D. Manali. 2nd Pulmonary Medicine Department, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, 1 Rimini Street, Athens, 12462, Greece. E-mail: fmanali@otenet.gr