Pulmonary contusion in children
- Matthew Eisenberg, MD
Matthew Eisenberg, MD
- Instructor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will discuss the epidemiology, clinical features, and management of pulmonary contusion in children. The approach to thoracic trauma in children and other thoracic injuries are presented elsewhere. (See "Initial evaluation and stabilization of children with thoracic trauma" and "Chest wall injuries in children" and "Overview of intrathoracic injuries in children".)
Pulmonary contusion is defined as pulmonary parenchymal damage with edema and hemorrhage, in the absence of an associated pulmonary laceration.
While thoracic injury in children is uncommon, occurring in only 4 to 8 percent of injured children identified through trauma registries or as patients at trauma centers [1-3], pulmonary contusion is the most commonly identified thoracic injury.
The vast majority of pulmonary contusions are the result of blunt trauma, usually involving a motor vehicle. In one retrospective series, 56 percent of injuries occurred in a motor vehicle crash, while 39 percent were the result of auto-pedestrian collisions .
The majority of patients with pulmonary contusions have associated thoracic injuries (eg, pleural effusion, pneumothorax, hemothorax, and fractures of the bony thorax) [4,5]. While flail chest and scapular fractures are uncommon in children, when present, they are typically associated with pulmonary contusion as well. (See "Chest wall injuries in children".)
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