Blast lung injury

Bilateral pulmonary contusion and alveolar tear from primary blast overpressure. The most lethal primary blast mechanism. Characterised at autopsy by bilateral 'butterfly' distribution haemorrhage, alveolar tear on microscopy, and frequent haemopneumothorax. No external wound. Identified in the JTTR dataset at 2.6% incidence with 28% mortality among US military blast casualties.