CTICasesLoculated Interlobar Hemopneumothorax
Imaging findings
Chest radiograph and subsequent CT demonstrate a large, well-defined, ovoid soft-tissue mass with an air-fluid level located within the left major fissure, demonstrating the classic incomplete border sign on the frontal view. The right chest shows acute rib fractures and surrounding extrapleural hematomas from remote trauma, with no acute fractures on the left.
Key takeaways
Trauma to the chest wall can cause bleeding into the pleural space. When blood collects within a fissure, it can form a loculated hematoma or interlobar pseudotumor. If a communication develops between the interlobar collection and an adjacent airway (a bronchopleural fistula), air enters the collection, resulting in a loculated hemopneumothorax with an air-fluid level within the fissure. This can be caused by contracoup injury relative to the side of direct trauma.
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