Abstract
A 16-year-old young woman with mental disorders was brought into our hospital after falling off from a height of approximately 10 meters. Computed tomography scan revealed acute subdural hematoma, blow-out fracture of left orbital floor, right mandibular fracture, bilateral pulmonary contusion, right pneumothorax without rib fractures, and multiple traumatic pulmonary pseudocysts (TPPs) in both lower lobes. After right chest drainage, massive air leak and hemosputum persisted. On the 25th hospital day, three-dimensional computed tomography revealed residual large two TPPs in the right lower lobe without being absorbed, each of which was considered to be the cause of intractable air leakage and hemosputum, respectively. Right lower lobectomy was performed because possible association of infection of the TPP was considered with elevated serum CRP. The patient's postoperative course was uneventful. A traumatic pulmonary pseudocyst develops following a blunt thoracic trauma and is generally treated conservatively. We should consider the surgical treatment as a therapeutic option for TPPs when they are associated with severe complications, such as refractory airway hemorrhage, persisting massive air leak, and secondary infection, or when they are kept unchanged.
