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Lung injury resulting from a nonaccidental crush injury to the chest
J McEniery1, R Hanson, W Grigor
1Children's Hospital, Camperdown, New South Wales, Australia.
Insights
Nonaccidental chest injury in infants can cause lung contusion and diffuse alveolar damage. Early diagnosis and conservative management are crucial for recovery.
Area of Science:
- Pediatrics
- Radiology
- Forensic Pathology
Background:
- Nonaccidental trauma is a significant cause of injury in infants.
- Pulmonary contusions can result from blunt chest trauma.
Observation:
- A six-week-old infant sustained rib trauma and lung contusion from nonaccidental compressive chest injury.
- The infant developed diffuse alveolar damage, worsening over 26 hours, complicated by pneumomediastinum.
Findings:
- The infant recovered with conservative management.
- Isotope bone scanning, in addition to X-rays, is valuable for diagnosing rib trauma.
Implications:
- Nonaccidental injury must be considered in the differential diagnosis of pulmonary contusion in infants.
- This case highlights the importance of a high index of suspicion for nonaccidental trauma in pediatric patients with chest injuries.
Abstract:
A six-week-old infant presented with rib trauma and a lung contusion from a nonaccidental compressive chest injury. He developed an illness consistent with diffuse alveolar damage, which worsened over 26 hours. This was complicated by a pneumomediastinum, and the patient recovered with conservative management. The value of isotope bone scanning in addition to x-rays is discussed. Nonaccidental injury should be considered in the differential diagnosis of a pulmonary contusion.