Pulmonary pseudocyst secondary to blunt or penetrating chest trauma: clinical course and diagnostic issues

Traumatic pulmonary pseudocysts (TPPs) are rare complications of chest trauma. The aim of this retrospective study was to report the clinical presentations, diagnosis, complications and treatment for a series of TPPs at a hospital in Turkey.

The patients were 42 males and 10 females aged 12–72 years (mean age 33.1 years). Forty-one had blunt trauma and 11 had penetrating trauma. There was no significant difference between the proportion of blunt trauma patients who developed TPP (41/761, 5.3 %) and the proportion of penetrating trauma patients who developed TPP (11/235, 4.6 %) (p > 0.05). All 42 patients had pulmonary contusion. Only 10 patients (19.2 %) had TPP identified on their chest X-ray, and thoracic computed tomography revealed TPP clearly in all these cases. Forty-two patients (80.7 %) were diagnosed with TPP on day 1 post-trauma. The hospital stays ranged from 2 to 35 days for the patients with blunt-trauma, and from 4 to 15 days for those with penetrating trauma (means 8.8 and 8.0 days, respectively; p > 0.05). Only one patient required thoracotomy for a pseudocyst that did not resolve and became progressively enlarged. This TPP was resected at 6 months post-trauma. One patient died on day 9 post-trauma due to multiple organ failure. The other 40 pseudocysts resolved spontaneously within 1–5 months.

Traumatic pulmonary pseudocysts are pulmonary lesions that occur after either blunt or penetrating trauma and tend to be overlooked. Most of these lesions are self-limiting, benign lesion.