Pulmonary laceration classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

In 1988, a group led by R.B. Wagner divided pulmonary lacerations into four types based on the manner in which the person was injured and indications found on a CT scan.[1]

  • In type 1 lacerations, which occur in the mid lung area, the air-filled lung bursts as a result of sudden compression of the chest.[1] Also called compression-rupture lacerations, type 1 are the most common type and usually occur in a central location of the lung. They tend to be large, ranging in size from 2–8 cm.[2]
  • The shearing stress in type 2 results when the lower chest is suddenly compressed and the lower lung is suddenly moved across the vertebral bodies.[1][2] Type 2, also called compression-shear, tends to occur near the spine and have an elongated shape.[2] Type 2 lacerations usually occur in younger people with more flexible chests.[3]
  • Type 3, which are caused by punctures from fractured ribs, occur in the area near the chest wall underlying the broken rib.[1] Also called rib penetration lacerations, type 3 lacerations tend to be small and accompanied by pneumothorax.[1] Commonly, more than one type 3 laceration will occur.[2] Type 4, also called adhesion tears, occur in cases where a pleuropulmonary adhesion had formed prior to the injury, in which the chest wall is suddenly fractured or pushed inwards.[2] They occur in the subpleural area and result from shearing forces at sites of transpleural adhesion.[3]

References

  1. 1.0 1.1 1.2 1.3 1.4 Wright F (2002). Radiology of the Chest and Related Conditions: Together with an Extensive Illustrative Collection of Radiographs. London: Taylor and Francis. p. 11.3. ISBN 0-415-28141-5. Retrieved 2008-05-05.
  2. 2.0 2.1 2.2 2.3 2.4 Thoongsuwan N, Kanne JP, Stern EJ (2005). "Spectrum of blunt chest injuries". Journal of Thoracic Imaging. 20 (2): 89–97. PMID 15818207. Unknown parameter |month= ignored (help)
  3. 3.0 3.1 Hollister M, Stern EJ, Steinberg KP (1995). "Type 2 pulmonary laceration: A marker of blunt high-energy injury to the lung". American Journal of Roentgenology. 165 (5): 1126. PMID 7572488. Unknown parameter |month= ignored (help)

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