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.
[4] A bronchopleural fistula results when there is a communication between the laceration, a bronchiole, and the pleura; it can cause air to leak into the pleural space despite the placement of a chest tube.
[5] Air can enter the circulatory system through a damaged vein in the injured chest and can travel to any organ; it is especially deadly in the heart or brain.
[5] Positive pressure ventilation can cause pulmonary embolism by forcing air out of injured lungs and into blood vessels.
[5] Pulmonary laceration is a common result of penetrating trauma but may also be caused by blunt trauma; broken ribs may perforate the lung, or the tissue may be torn due to shearing forces[5] that result from different rates of acceleration or deceleration of different tissues of the lung.
[12] A pneumatocele can become enlarged, for example when the patient is mechanically ventilated or has acute respiratory distress syndrome, in which case it may not go away for months.
[12] Pulmonary hematomas take longer to heal than simple pneumatoceles and commonly leave the lungs scarred.
[14] Over time, the walls of lung lacerations tend to grow thicker due to edema and bleeding at the edges.
[1][9] As the lung contusion clears (usually within two to four days), lacerations begin to become visible on chest X-ray.
[12] Before CT scanning was widely available, pulmonary laceration was considered unusual because it was not common to find with X-ray alone.
[4] A single laceration may occur by itself, or many may be present, creating an appearance like Swiss cheese in the radiography of the lung.
Wagner divided pulmonary lacerations into four types based on the manner in which the person was injured and indications found on a CT scan.
[20] Pulmonary laceration usually heals quickly after a chest tube is inserted and is usually not associated with major long-term problems.