What Is a Pulmonary Contusion?

Clara Kedrek

A pulmonary contusion, also known as a lung contusion, occurs when the lung is injured by external trauma. The damage to the lung can cause a range of symptoms including shortness of breath, chest pain, and problems breathing. Diagnosis of a lung contusion can be suspected based on the patient’s symptoms, but is often best confirmed by imaging studies including chest x-rays or computed tomography (CT) scans. Treatment of the condition focuses on offering patients respiratory support to give their damaged lungs a chance to heal.

Chest x-rays may help doctors diagnose a pulmonary contusion.
Chest x-rays may help doctors diagnose a pulmonary contusion.

In short, a pulmonary contusion can be thought of as a bruise of the lung. Being exposed to trauma — for example, from a car accident — can damage the wall of the chest and the lung tissue located inside of the body. The damaged tissue bleeds, and cannot properly expand with air as the patient breathes in and out.

Damaged lung tissue can bleed, making it difficult for it to expand as the patient breathes in and out.
Damaged lung tissue can bleed, making it difficult for it to expand as the patient breathes in and out.

Symptoms of a pulmonary contusion can vary depending on the severity of the injury. One of the most common symptoms is shortness of breath. Affected patients might need to breathe in at a faster rate compared to healthy people, and might not be able to breathe in as deeply compared to other people. Other symptoms can include pain located in the chest wall, coughing, and pain with breathing. Severely affected patients might not get enough oxygen, and can develop life-threatening symptoms, such as unconsciousness. Often it takes between two to three days before the damage causes symptoms to occur.

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A pulmonary contusion may be diagnosed through a CT scan.
A pulmonary contusion may be diagnosed through a CT scan.

Diagnosis of a pulmonary contusion focuses on integrating symptoms, physical exam findings, and results of imaging studies. On examining patients with this condition, doctors or other health care professionals might note that patients appear to be having difficult time breathing. They might have external signs of trauma, such as bruising or bleeding of the skin. On chest x-ray, a lung contusion might appear as a visual abnormality of the lung tissue. A CT scan of the chest is more sensitive in picking up this type of injury.

People with a pulmonary contusion often require supplemental oxygen due to shortness of breath.
People with a pulmonary contusion often require supplemental oxygen due to shortness of breath.

Treatment of a pulmonary contusion is typically supportive. In other words, there is no true cure for the condition, but the symptoms patients experience from the injury can be alleviated. For shortness of breath, patients can be given supplemental oxygen, administered through a face mask or nasal probe. In severe cases, patients can be intubated in order to ensure they obtain the oxygen they need while getting rid of the carbon dioxide produced by the body. With these supportive measures, the lung is given an opportunity to heal itself and re-establish normal respiratory function.

A pulmonary contusion may cause shortness of breath and chest pain.
A pulmonary contusion may cause shortness of breath and chest pain.
It can often take two to three days before symptoms of a pulmonary contusion, such as chest pain, appear.
It can often take two to three days before symptoms of a pulmonary contusion, such as chest pain, appear.

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