[Traumatic Lung Injury].

Thoracic injuries are significant causes of morbidity and mortality in trauma patients. Traumatic pulmonary contusion and/or laceration are often observed in patients with chest trauma, explosion injuries or a shock wave associated with penetrating trauma. A pulmonary contusion is an injury to the lung parenchyma without actual structural damage. As a result of damage to alveoli and capillaries, it results in leakage of blood and other interstitial fluids across the alveolar-capillary membrane into lung tissue and alveolar space. Since oxygenated air can not enter into fluid-filled alveoli, hypoventilation and decreased perfusion by reflux vasoconstriction result in hypoxemia and hypercapnia. Pulmonary laceration is a lung injury with disruption of the architecture of the lung, while pulmonary contusion does not. There is almost always concurrent pulmonary contusion, and pneumothorax, hemothorax, or hemopneumothorax. In addition, pulmonary laceration can be a cause of forming a cyst or hematoma, which usually disappears over a period of weeks or months. However, pneumatocele can occur in some cases when lacerations are enlarged with air-filled cavity. It is important for thoracic surgeons to understand pathophysiology of traumatic lung injury, and to know the diagnosis and treatment.