Pulmonary contusion

what is a contusion

an area of injured tissue where blood capillaries have ruptured (bruise)

what is a pulmonary contusion

a bruise of the lung tissue where capillaries in the parenchyma are damaged due to blunt trauma

what commonly causes a pulmonary contusion

blunt chest trauma, often associated with rib fractures

what anatomical changes occur in a pulmonary contusion

lung tissue injury, capillary damage, and a local inflammatory response that can spread over 48 hours

what happens as fluid leaks into the interstitial and alveolar spaces

lung compliance decreases, and surfactant becomes diluted

what complications can result from pulmonary contusion

atelectasis and potentially progression to ARDS

what is the main pathophysiologic mechanism in pulmonary contusion

shunting due to uneven ventilation of affected alveoli

why does shunting occur in pulmonary contusion

fluid buildup from injured capillaries causes edema and decreased compliance, making alveoli harder to inflate

which alveoli receive most ventilation in pulmonary contusion

the healthy alveoli, since affected ones are congested and stiff

when do symptoms of pulmonary contusion typically appear

hours after the injury, not immediately in the ER

what imaging test is used to diagnose pulmonary contusion

chest xray, though a CT scan is more sensitive

what might a chest xray show immediately after a pulmonary contusion

mild fluffy opacities, indicating early fluid accumulation

how do chest xray findings change after 24-48 hours

the fluffy opacities increase, showing progression of the contusion

what are typical patient presentation signs of pulmonary contusion

chest trauma, pain, mild hypoxemia, and difficulty clearing secretions

when does respiratory distress develop in pulmonary contusion

as the inflammatory response progresses, leading to worsening hypoxemia

what auscultation findings are common with pulmonary contusion

fine inspiratory crackles and diminished air entry, especially where atelectasis is present

is there a specific treatment for pulmonary contusion

no, only supportive care

what are common supportive treatments for pulmonary contusion

oxygen therapy, mechanical ventilation if needed, and pain management

how long do uncomplicated pulmonary contusions usually take to resolve

3-5 days

what is a common complication of pulmonary contusion related to secretion clearance

pneumonia due to fluid accumulation and difficulty clearing secretions

what severe complication can develop in up to 50% of pulmonary contusion patients

ARDS

what increases the risk of developing ARDS after a pulmonary contusion

the size of the contusion