The causes, symptoms and treatments behind a bruised lung

2013-12-17 14:40:28 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

Ming Barkevious Mingo / Read the Plain Dealer story.

Brownsí first-round draft pick Barkevious Mingo recently suffered a bruised lung and many are asking when he will return to play.

Itís an injury that historically is not very common in sports, but weíre starting to see it more due to bigger, faster, stronger players.

Today, I had the chance to speak with WAKR host Ray Horner about his injury.

We discussed the causes, symptoms and treatments of a bruised lung ó known in medical circles as a pulmonary contusion.

Though it can be a serious injury, the body can heal itself in about a week.

Below is an audio file and transcript of our discussion.



 

HORNER: Joining us right now ó speaking of sports from a couple moments ago ó is Dr. Joe Congeni from Sports Medicine Center, Akron Childrenís Hospital. Good morning, Joe.

DR. CONGENI: Hey, Ray. How are ya?

HORNER: Iím doing well. Iím getting anxious for the football season, my friend.

DR. CONGENI: Yeah, itís a great time of year. Itís a fun time of year in Northeast Ohio.

HORNER: Yeah, already most of the fall sports teams are already in action though. I know that.

DR. CONGENI: Yeah, you gotta start early, especially some of those sports where you donít want to get too cold, like tennis and golf and things like that.Youíre right. Theyíre at it in August.

HORNER: What do you have for us today?

DR. CONGENI: Well Ö it wouldnít be a first-round draft pick if we didnít have some weird injury. So, Barkevious Mingo (linebacker for the Cleveland Browns) and what is the bruised lung?

You know, we like to use a lot of medical terms that sometimes we have to explain what some of these terms are, but the bruised lung is known in medical circles as a pulmonary contusion.

When you look back in the sports medicine textbooks before 2005 and stuff, they said very, very rare in sports. But, weíre starting to see it more frequently. You know what my thought on that is some of the collisions now that we see are much more significant as the players are bigger and stronger and faster.

Dr. Joe Congeni Dr. Joe Congeni

And in the same week that Barkevious Mingo had a bruised lung, Eddie Royal, the wide receiver from San Diego, had one.

A year or two ago, Andre Johnson (wide receiver for the Houston Texans) missed some time with a bruised lung.

The lungs are like sponges, so they give a lot and it takes a very significant blow to the chest, a blunt trauma, to get this injury.

The tears the capillaries, the small blood vessels in the lungs, and they bleed into the air sacs. The air sacs at the end of the breathing tubes are called alveoli, and when they get filled with blood, they donít work well.

Depending on how many of these are filled with blood in a pulmonary contusion tells you how bad this injury is.

The mechanism is a blunt blow. In ERs, most of the time, Ray, this is gonna be somebody who falls from a height, or somebody thatís in a car crash with particularly a steering wheel injury.

Theyíre not that common in sports at all. In the sports where they are most common are skiing, you know high-velocity sports, snowboarding, horseback riding, but weíre starting to see them more and more in football.

The symptoms you might expect on the sidelines are chest pain, but thatís very common. Shortness of breath where an athlete just canít catch his breath and it just wonít go away.

You know, usually when an athlete comes over on the sidelines, if they are having trouble breathing, he will recover fairly quickly, but these people wonít recover. They just canít catch their breath.

The hallmark symptom is coughing up blood. We call that hemoptysis. Sometimes in the real severe cases, you can actually start seeing a bluish color to the lips. That would be a very significant contusion, or lung bruise. You can listen with your stethoscope and you hear this crackly sound, rales is the name of it.

In an emergency room, an X-Ray shows it very quickly. We usually donít have to do a fancy study, like a CT scan, although in a big first-round draft pick, Iím sure they did every test in trying to evaluate him. An X-Ray will show a pulmonary contusion, a bruised lung.

One of the big tests in the emergency room is where they put that monitor on your finger to see the oxygen saturation. People that are really struggling, if that percentage of blood oxygen saturation drops below 90, they have to start talking about intubating and putting somebody on a ventilator. So, yeah, these can be life-threatening, these bruised lung issues.

Of course, the thing everybody wants to know is when can Barkevious Mingo return to play. Usually, in these cases, it takes about seven days. The body will within a week heal these bad deep bruises and the bleeding in the air sacs.

Within a week to 10 days, players can get back, which is about where weíre at and weíll see what happens with Barkevious Mingo. Then, guys wear rib pads or flak jackets to protect them from having these again.

But, itís not that common of an injury. We are starting to see it more frequently and itís kinda scary because a really bad bruised lung can land somebody in the hospital for a long time and even put Ďem on a respirator in some really bad situations.

HORNER: Joe, credit the sports medicine staff there with the Browns. You know, they came under the gun last year with the Colt McCoy concussion and everything, but they acted promptly on this situation last week.

DR. CONGENI: Youíre exactly right, and you know what? They are almost now looking at the sideline like an emergency room. Some of the people they have up there are almost trained like itís a mini emergency room there.

You know all the trainers that are on the sidelines ó youíre out there with the freshman games, and JV games and varsity games ó they have to make quick decisions on these guys.

Chest pains are a pretty common ó not every kid is going to be coughing up blood.

But, one hallmark for any coach or trainer out there, if a kidís coughing up blood thatís probably one of these bruised lungs and you donít want to wait on that. Thatís an automatic ticket to send a kid to an emergency room because we need further testing then to see if this kid could go downhill pretty quickly.

HORNER: Alright, Joe, great education as always. Weíll catch up with you next week and weíll see you next Thursday.

DR. CONGENI: Weíre waiting for the kickoff, Ray. Thanks. Take Care.

HORNER: Dr. Joe Congeni, Sports Medicine Center at Childrenís Hospital, joining us.

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