Objective:Unusual clinical course Background:Traumatic pulmonary pneumatoceles (TPP) are rare sequelae of chest trauma, most commonly observed in children due to their compliant chest wall.While typically self-limiting and resolving within weeks to months, large or long-term persistent lesions can pose diagnostic and therapeutic challenges. Case Report:We present the case of a 1-year-old boy who sustained severe head and blunt thoracic trauma following a highimpact motor vehicle accident.Chest computed tomography revealed 2 large right-sided pulmonary pneumatoceles, measuring up to 52 mm, associated with pulmonary contusions and a small pneumothorax.In accordance with a collegial agreement between the various medical specialties and with parental involvement and consent, a conservative management strategy was adopted, including mechanical ventilation and close monitoring without chest tube placement.Over an extended follow-up period of 8 years 5 months, one lesion resolved completely, while the other evolved into a stable, thin-walled cavity.The patient remained asymptomatic throughout, with no respiratory complications or functional limitations. Conclusions:This case, featuring one of the longest documented radiological follow-ups, demonstrates that large pediatric TPPs can persist for years without clinical or functional impairment.Our findings suggest that lesion size alone should not mandate invasive intervention; rather, for asymptomatic patients, conservative management with vigilant surveillance is a safe and effective alternative to surgery.
Chaari et al. (Tue,) studied this question.
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