Posttraumatic pulmonary pseudocyst

• DOI: 10.1097/ta.0b013e318265ccb9
• Publication Date: 2012-08-24T07:35:08Z
• Authors: Liangping Luo; Liang Yin; Zaosong Liu; Ziyun Xiang
• Keywords: Adult; Lung Diseases; Male; Adolescent; Thoracic Injuries; Cysts; Patient Selection; Middle Aged; Wounds, Nonpenetrating; 3. Good health; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Female; Child; Emergency Service, Hospital; Tomography, X-Ray Computed; Aged; Retrospective Studies

Posttraumatic pulmonary pseudocyst (PPP) is a complication of blunt chest trauma and poorly documented. A retrospective review of PPPs observed during the past 6 years in our hospitals is presented in this report.We retrospectively studied the serial chest computed tomographic scans and clinical data of 33 consecutive patients with PPPs.Fifty-three PPPs from 33 patients were found. Thirty-six PPPs were located in the subpleural pulmonary parenchyma, whereas others were located in the pulmonary parenchyma near other harder structures. Follow-up examinations demonstrated that air-filled cavities and air-fluid cavities could turn into pulmonary hematomas and eventually resolved without specific treatment. The PPPs were resolved in 11 to 82 days. The resolving time of air-fluid cavity (mean, 47.5 days) was significantly longer than the resolving time of air-filled cavity (mean, 16.3 days; p = 0.001). Three patients died of acute respiratory distress syndrome or head trauma. No patient died of PPP. Twelve patients with serious pneumothorax, hemothorax, or both were cured with surgical hemostasis and/or drainage. Eighteen patients resolved without specific treatment.Computed tomography increased the frequency of PPP diagnosis and accurately demonstrated the characteristics of the lesions. Air-filled pseudocysts resolved more quickly than those containing fluid. The outcome of PPPs can be favorable without specific treatment. PPP does not require follow-up CT scan or intervention in the absence of complications.Prognostic/epidemiologic study, level V.