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What is a pulmonary contusion?

A pulmonary contusion is a potentially serious injury. It occurs when the lung's parenchyma is injured. This leads to swelling and the collection of fluids, which is known as edema. Blood and fluids collect in the alveolar spaces, which makes it hard for the lungs to function correctly. As a result, those with a pulmonary contusion may need breathing assistance with a ventilator.

Approximately 40 to 60 percent of patients who develop significant pulmonary contusions will need to use a ventilator until the contusion, which is a bruise, resolves. If a patient is not identified as having Acute Respiratory Distress Syndrome, a complication of bilateral contusions, he or she may pass away. The data shows a mortality rate of approximately 10 to 25 percent.

After a car accident, it's important to get a chest X-ray to identify pulmonary contusions. These are not able to be seen in a typical exam, although there may be signs such as bruising on the skin and broken ribs that could mean the lungs are bleeding below the surface. The full extent of the injury won't appear fully on an X-ray until 24 to 48 hours after the injury, so it's important to understand that the X-ray is likely not showing the true severity of the condition. If a contusion is diagnosed, then a computed tomography scan, or CT scan, should be used to identify the full extent of the injury. The scan is highly accurate compared to an X-ray, since it allows for a three-dimensional image.

This injury takes time to appear, but it can have life-threatening consequences. This is why you need to go to the hospital after a crash, even if you think you're okay.

Source: Trauma.org, "Chest Trauma- Pulmonary Contusion," accessed Aug. 10, 2017

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