Traumatic pneumatoceles in an infant: case report and review of the literature.

A female infant who was run over by a tractor was admitted to an outside trauma unit. In addition to severe intraabdominal injuries, she sustained blunt chest trauma. In the right lung she developed pneumatoceles 48 hours after the trauma which were misinterpreted as pneumothorax on repeated chest x-rays. Several attempts to drain the right pleural cavity failed and the patient died five days after the trauma just before referral. Compression of an elastic thorax is followed by a greatly increased negative intrathoracic pressure on chest rebound and this sequence of events causes bursting lesions of the lung resulting in traumatic intrapulmonary cysts, the so-called pneumatoceles. One must be aware that pneumatoceles can develop and initial diagnosis is difficult. Although usually uncomplicated, a pneumatocele that does not progressively become smaller can be a life-threatening complication of blunt chest trauma and surgical resection is recommended.