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Objective: We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance.
Design: Retrospective Cohort study
Setting: Level 1 pediatric trauma center
Patients: Children in trauma registry diagnosed with pulmonary contusion
Interventions: None
Main Outcome Measure(s): . Patient demographics, mechanism of injury, injury severity score, diagnosis and procedure codes, length of hospital stay, outcome, imaging techniques and findings with attention to the identification of a pneumatocele
Results:
Of the 204 children identified with blunt or penetrating pulmonary contusion, 26 (13%) were diagnosed with a pneumatocele. Their mean age was 13 years (3-17). Seventy-seven percent (20) were male. The most common mechanism of injury was a motor vehicle collision (10), followed by falls (6). The mean Injury Severity Score was 17 (9-34). There were no fatalities. Eight patients were found to have a solitary pneumatocele and 18 patients had 2 or more. The largest pneumatocele was 3.7 cm in diameter. Ten children (38%) were admitted to the intensive care unit, 3 of whom required intubation. One patient (4%) had a respiratory complication: aspiration pneumonia. No child underwent intervention specific to the pneumatocele. One child (4%) underwent a follow-up chest CT to rule out a congenital pulmonary malformation 6 months after injury and this demonstrated complete resolution of the pneumatocele.
Conclusion: The incidence of pneumatoceles among children with a pulmonary contusion was 13% in this series, but is probably higher given that only 15% were visible on radiographs. Pneumatoceles are common in children with pulmonary contusions, but are usually small and clinically insignificant.