Lungenkontusion nach Sprung ins Wasser

Zusammenfassung

Hintergrund Zu Lungenkontusionen kommt es häufig im Rahmen von Polytraumata, aber deutlich seltener bei Sportverletzungen.

Fallbeschreibung Wir berichten über einen 22-jährigen Patienten, der sich fußläufig in unserer Notaufnahme vorstellte. Er war am selben Tag im Schwimmbad von einem 10-Meter-Turm gesprungen und dabei mit dem ventralen Thorax und Abdomen auf die Wasseroberfläche geschlagen. Unmittelbar danach kam es zu rechtsthorakalen Schmerzen und Hämoptysen.

Der körperliche Untersuchungsbefund blieb ohne weitere Auffälligkeiten. Im Röntgenthorax in 2 Ebenen ergab sich ebenfalls kein eindeutig pathologsicher Befund.

Das Computertomogramm des Thorax mit Kontrastmittel wies eine inhomogene Verdichtung im Mittellappen und geringer im ventrobasalen Oberlappen rechts auf, passend zur Lungenkontusion mit Parenchymblutungen. Zusätzlich zeigte sich ein minimaler Pneumothoraxsaum rechts parakardial.

In der am selben Tag durchgeführten Bronchoskopie wurden im Mittellappenbronchus geringe Mengen Blut nachgewiesen.

Die Hämoptysen sistierten spontan. Am dritten Tag des stationären Aufenthaltes wurde der Patient asymptomatisch und mit stabilen Vitalparametern entlassen.

Schlussfolgerung Infolge einer Lungenkontusion kann es unmittelbar nach einer Thoraxverletzung im sportlichen Umfeld zu Hämoptysen kommen. Im Gegensatz zum konventionellen Röntgen-Thorax kommt der Computertomografie in der Diagnostik der Lungenkontusion ein hoher Stellenwert zu. Meistens sind die o.g. Befunde spontan reversibel.

Abstract

Background Lung contusions often occur in the context of polytrauma, but much less frequently in sports injuries.

Case description We report on a 22-year-old patient who presented to our emergency room. On the same day he jumped from a 10 meter tower in a swimming pool and hit the surface of the water with his thorax and abdomen. He complained of pain in the right chest and hemoptysis immediately after the jump.

The examination findings remained without further abnormalities.

In the chest x-ray no abnormalities were found.

The CT thorax with contrast medium revealed homogeneous ground-glass opacities in the middle lobe and less in the ventrobasal upper lobe on the right, consistent with the pulmonary contusion with parenchymal bleeding. In addition, there was a minimal pneumothorax border on the paracardial right side.

Bronchoscopy performed on the same day showed evidence of blood in the middle lobe bronchus.

The hemoptysis stopped spontaneously. On the 3rd day of the hospital stay, the patient was discharged with stable vital parameters and asymptomatic.

Conclusion Hemoptysis immediately after a sports chest injury may occur as a result of pulmonary contusion. In contrast to conventional chest x-rays, computed tomography is of great importance in the diagnosis of pulmonary contusion.

Schlüsselwörter

Lungenkontusion - Bronchoskopie - Pneumothorax - Hämoptysen - 10-Meter-Sprung

Keywords

lung contusion - broncoscopy - pneumothorax - Hemoptysis - 10 meter jump

Publication History

Received: 26 July 2022

Accepted after revision: 13 December 2022

Article published online:
23 March 2023

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