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Pulmonary Contusion

By Thomas G. Weiser, MD, MPH, Associate Professor, Department of Surgery, Section of Trauma & Critical Care, Stanford University School of Medicine

A pulmonary contusion is a bruise of a lung, which causes bleeding and swelling.

  • People have pain, usually due to the chest wall injury, and often feel short of breath.

  • Doctors make the diagnosis with a chest x-ray.

  • Treatment is with oxygen and sometimes a ventilator to support breathing until the bruise heals.

A severe blow to the chest (as from a motor vehicle crash or fall) can bruise the lung. The bruised lung does not absorb oxygen properly. A large bruise can cause dangerously low levels of oxygen in the bloodstream. A severe pulmonary contusion is potentially life-threatening.

People may also have rib fractures, a collapsed lung (pneumothorax), and other chest injuries. Later on, people may develop pneumonia or acute respiratory distress syndrome.


Pain and shortness of breath are the main symptoms. The pain is usually caused by injury to the chest wall (the ribs and chest muscle). Breathing is painful and difficult.

People may have no symptoms, especially at first. Shortness of breath may develop and worsen over several hours.


  • Chest x-ray

Doctors suspect a pulmonary contusion when people become short of breath after a chest injury, especially if shortness of breath develops gradually.

A chest x-ray is taken. However, because a contusion may develop gradually, doctors may take more than one x-ray over a period of many hours to detect a contusion.

Doctors also measure the amount of oxygen in the blood by attaching a device to a finger or toe (pulse oximeter). This information can help doctors determine how well the lungs are functioning.


  • Analgesics and oxygen therapy

People are usually given pain relievers (analgesics) to lessen pain and thus help them breathe more easily.

People may need oxygen therapy or sometimes mechanical ventilation to help with breathing while the injury heals.