page_title: Pulmonary laceration
section_title: Diagnosis
hierarchical_section_title: Pulmonary laceration / Diagnosis
caption_attribution_description: Chest X-ray of a pulmonary contusion
context_page_description: A pulmonary laceration is a chest injury in which lung tissue is torn or cut. An injury that is potentially more serious than pulmonary contusion, pulmonary laceration involves disruption of the architecture of the lung, while pulmonary contusion does not. Pulmonary laceration is commonly caused by penetrating trauma but may also result from forces involved in blunt trauma such as shear stress. A cavity filled with blood, air, or both can form. The injury is diagnosed when collections of air or fluid are found on a CT scan of the chest. Surgery may be required to stitch the laceration, to drain blood, or even to remove injured parts of the lung. The injury commonly heals quickly with few problems if it is given proper treatment; however it may be associated with scarring of the lung or other complications.
context_section_description: Pulmonary laceration may not be visible using chest X-ray because an associated pulmonary contusion or hemorrhage may mask it. As the lung contusion clears (usually within two to four days), lacerations begin to become visible on chest X-ray. CT scanning is more sensitive and better at detecting pulmonary laceration than X-rays are,  and often reveals multiple lacerations in cases where chest X-ray showed only a contusion. Before CT scanning was widely available, pulmonary laceration was considered unusual because it was not common to find with X-ray alone. On a CT scan, pulmonary lacerations show up in a contused area of the lung, typically appearing as cavities filled with air or fluid that usually have a round or ovoid shape due to the lung's elasticity.
  Hematomas appear on chest radiographs as smooth masses that are round or ovoid in shape.  Like lacerations, hematomas may initially be hidden on X-ray by lung contusions, but they become more apparent as the contusion begins to heal.  Pneumatoceles have a similar shape to that of hematomas but have thin, smooth walls.  Lacerations may be filled completely with blood, completely with air, or partially with both.  Lacerations filled with both blood and air display a distinctive air-fluid level.  A single laceration may occur by itself, or many may be present, creating an appearance like Swiss cheese in the radiography of the lung.
  Pulmonary laceration is usually accompanied by hemoptysis (coughing up blood or of blood-stained sputum).
  Thoracoscopy may be used in both diagnosis and treatment of pulmonary laceration.
  A healing laceration may resemble a lung nodule on radiographs, but unlike pulmonary nodules, lacerations decrease in size over time on radiographs.
caption: A chest X-ray of a right sided pulmonary contusion associated with flail chest and subcutaneous emphysema.  Contusion may mask pulmonary laceration on chest X-ray.
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