Yanagawa Youichi
Department of Traumatology and Critical Care Medicine, National Defense Medical College (NDMC), Saitama 359-8513, Japan.
Am J Emerg Med. 2009 Feb;27(2):249.e3-4. doi: 10.1016/j.ajem.2008.05.027.
An 8-year-old boy was struck by a truck, and the impact carried him 10 m away from the scene. On arrival at the hospital, his chest and left thigh roentgenograms revealed fractures of the left clavicle, scapular, and left femur shaft. His chest computed tomography scan demonstrated right dominant bilateral multiple ill-defined and hazy ground-glass density areas 70 minutes after the accident. He was treated with conservative therapy with 2 L/min of oxygen. On the fourth hospital day, the chest computed tomography scan revealed the disappearance of most of the pulmonary lesions. Based on the natural time course of pulmonary contusions, it was impossible to explain why most of the pulmonary lesions in this patient disappeared within 4 days. A transient malfunction of the blood-gas barrier in the alveoli induced by blunt trauma might lead to the generation of lung edema.