Citation Information :
Muthe MM, Rai PR, Joshi AR, Firke VP. Out of Breath, Out of Bounds: A Case Report of Traumatic Lung Herniation. 2023; 2 (4):113-116.
Introduction: Intercostal lung herniation is characterized by congenital or acquired herniation of the lung or other viscera through the thoracic wall.
Case description: A young adult male presented with a history of trauma to the chest due to the handlebar of a bicycle. Chest radiograph findings were concerning for a lung contusion, mild pneumothorax, and hemothorax. A computed tomography (CT) scan in addition showed herniation of lung parenchyma along the anterior aspect of the left second rib. Given the relatively small size of the defect, the patient underwent a reduction of the herniated lung, followed by primary closure. He had an uneventful postoperative period and was doing well on follow-up.
Discussion and conclusion: Computed tomography (CT) plays a crucial role in selecting the appropriate management approach in the intercostal lung herniation. The goals of imaging are to assess the defect size, lung viability, and severity of the injury and rule out other trauma-related findings. Small defects with minimal herniation are amenable to conservative management, but those with large defects and/or disruption of the thoracic wall require surgery with flap/mesh reconstruction. With prompt treatment, these patients are expected to have good long-term functional outcomes.
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