Pulmonary laceration, contusion and barotrauma - severe car airbag injury
Diagnosis certain
Presentation
Car hit a tree, airbags deployed. Severe shortness of breath with hemoptysis. Paramedics inserted a chest tube at scene as poor air entry on the left.
Patient Data
Age: 25 years
Gender: Male
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Marked asymmetrical alveolar opacity (hemorrhage) in entire left lung with air cysts i.e. traumatic pneumatoceles (arrows) as well as marked mediastinal emphysema and minor splenic laceration (arrow). Note no rib fractures although there is a left clavicular fracture.
Case Discussion
These appearances are typical of barotrauma i.e. rapid deceleration force due to impact with the deployed airbags. They have worked to prevent fractures but as a result there is diffuse pulmonary hemorrhage and laceration leading to traumatic air cysts.