Large Traumatic Pneumatocele in a 2-Year-Old Child

N K Cheung,A James,R Kumar

doi:10.1155/2013/940189

Abstract

Traumatic pneumatoceles are a rare complication of blunt chest trauma in children. Although they characteristically present as small, regular shaped lesions which can be safely treated nonoperatively, larger traumatic pneumatoceles pose diagnostic and management difficulties for clinicians. This case study reports one of the largest traumatic pneumatoceles reported to date in the paediatric population, which resulted in aggressive surgical intervention for both diagnostic and treatment reasons. This case adds further evidence to the current literature that significantly large traumatic pneumatoceles with failure of initial conservative management warrant surgical exploration and management to optimise recovery and prevent complications.

Highlights

Traumatic pneumatocele (TP) is a rare condition occurring after blunt chest trauma in children and young adults, accounting for 3.9% of paediatric blunt chest traumas
TP is characterized by the appearance of pulmonary cavities with no epithelial lining filled with air, fluid or, blood seen on radiology imaging, which usually resolve without surgery
Conservative treatment is recommended when TP can be correctly diagnosed [2, 7], dilemmas with their optimal management can arise with more complicated cases due to a paucity of paediatric case studies described in the literature

Summary

Introduction

Traumatic pneumatocele (TP) is a rare condition occurring after blunt chest trauma in children and young adults, accounting for 3.9% of paediatric blunt chest traumas. In the literature, it has been described as traumatic pneumatoceles, traumatic lung cysts, pulmonary cavitations, cavitating haematoma, and traumatic pulmonary pseudocysts [1,2,3,4,5,6]. TP is characterized by the appearance of pulmonary cavities with no epithelial lining filled with air, fluid or, blood seen on radiology imaging, which usually resolve without surgery It is commonly associated with pulmonary contusions but represents more extensive tissue disruptions and severity of injuries than a simple contusion [2, 3]. This report presents an unusual case of a very large traumatic pneumatocele resulting in surgical management to improve recovery time and to exclude serious underlying pathology and complications

Case Presentation

Discussion

Findings

Disclosure