Pulmonary Contusion, Causes, and Symptoms

The recipient of the AAST Honorary Medal for Combat Surgery 2005, Dr. Jay Johannigman is a trauma and critical care surgeon at the Brooke Army Medical Center. Jay Johannigman, MD has dedicated extensive research efforts to academic medicine, one of which examined the impact of combined differential lung ventilation and inhaled nitric oxide therapy in the management of unilateral pulmonary contusion.

A lung injury that happens when the chest is subjected to a blunt or penetrating trauma, pulmonary contusion, also known as bruised lung, is potentially lethal and can result in life-threatening complications if not treated. When pulmonary contusion occurs, significant areas of the lung are bruised, however, laceration or tear may be absent. The bruising is a direct result of damaged alveolar blood vessels from traumatic impact, which causes fluid to build up in spaces that were normally filled with air — thus, reducing the lung capacity to convey oxygen to the blood. Common symptoms are chest pain, difficulty breathing, increased heart rate, coughing, and fatigue.

A pulmonary contusion can result from a car accident, physical assault, fall, or sports injury. Sometimes, it occurs alongside other injuries — such as spinal fracture, lung tear, injury to abdominal organs, hemothorax (blood in the lung), and broken ribs. More severe signs of a pulmonary contusion can include hemoptysis (coughing up blood), blue-tinged skin (cyanosis), wheezing, cool or clammy skin, and low blood pressure. Treatment generally depends on the severity of the injury and whether the patient’s breathing is affected. Mild bruises may get better in days.