Primary traumatic pulmonary pseudocysts: a rare entity

Objective: Pulmonary contusion is the usual manifestation of lung parenchymal injury after blunt chest trauma. With deceleration these parenchymal lacerations can result in cavities known as primary traumatic pulmonary pseudocysts (TPPC). We present our experience in treating this rare entity. Material: From 1989 trough 1999, 14 young patients, 11 male and three female ranging in age between 13 and 24 years were treated for primary TPPC in our department. Blunt chest injuries resulting from traffic accidents were the causes in all our cases. The main symptoms were pain, hemoptysis and dyspnea not associated with severe hypoxemia. The cavitary lesion was apparent in chest radiographs, but the imaging modality of choice was the computed tomography. Results: Multisystem injury was present in 7 of them. Two of our patients required ICU facilities but none needed mechanical ventilation. Hemopneumothorax was present in two cases, whereas pneumothorax in four drained by tube thoracostomy. The hospital stay ranged between 9 and 23 days. Contraction and complete radiological resolution of the PPC needed a follow up of 6-11 weeks. Conclusions: (1) Primary traumatic pulmonary pseudocysts are benign lesions secondary to blunt chest trauma needing only conservative treatment unless complications arise, such as hemo- or pneumothorax or infection of the cavitary lesion. (2) Computed tomography is a really sensitive method for early detection of the lesion while plain roentgenograms are sufficient for the follow up. (C) 2002 Elsevier Science B.V. All rights reserved.