Indian Journal of Critical Care Case Report

Register      Login

VOLUME 2 , ISSUE 4 ( July-August, 2023 ) > List of Articles


Out of Breath, Out of Bounds: A Case Report of Traumatic Lung Herniation

Mridula M Muthe, Pareekshith R Rai, Anagha R Joshi, Vikrant P Firke

Keywords : Case report, Computed tomography chest, Hernia, Lung herniation, Thoracoscopy, Traumatic

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.

DOI: 10.5005/jp-journals-11006-0069

License: CC BY-NC 4.0

Published Online: 18-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


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.

  1. Gupta S, Choksi K, Chauhan G, et al. Conservative management of traumatic intercostal lung hernia: a case report. J Clin Diagn Res 2022;16(1):PD01–PD03. DOI: 10.7860/jcdr/2022/52117.15828
  2. Tapsoba TW, Grapin-Dagorno C, Bonnard A, et al. Isolated congenital inter-costal pulmonary hernia: a case report. J Med Case Rep 2019;13(1):232. DOI: 10.1186/s13256-019-2142-4
  3. Hamid M, Ghani AR, Ullah W, et al. Spontaneous lung herniation leading to extensive subcutaneous emphysema, pneumothorax, pneumomediastinum, and pneumopericardium. Cureus 2018;10(6):e2861. DOI: 10.7759/cureus.2861
  4. Morales Borrero WJ, Madonado Vargas J. A 64-year-old man with traumatic right middle lobe lung herniation successfully managed conservatively. Am J Case Rep 2021;22:e931446. DOI: 10.12659/ajcr.931446
  5. Detorakis EE, Androulidakis E. Intercostal lung herniation - the role of imaging. J Radiol Case Rep 2014;8(4):16–24. DOI: 10.3941/jrcr.v8i4.1606
  6. Carrouget J, Hoarau N, Duverne C, et al. Conservative management of traumatic intercostal lung herniation in a child. J Pediatr Surg Case Rep 2015;3(2):44–45. DOI: 10.1016/j.epsc.2014.11.015
  7. Bhalla M, Leitman BS, Forcade C, et al. Lung hernia: radiographic features. AJR Am J Roentgenol 1990;154(1):51–53. DOI: 10.2214/ajr.154.1.2104725
  8. Pérez Castro P, Undurraga Machicao F, Santolaya Cohen R, et al. Minimally invasive management of traumatic lung herniation. J Surg Case Rep 2017;2017(7):rjx130. DOI: 10.1093/jscr/rjx130
  9. Chiang TY, Yin MF, Yang SM, et al. Thoracoscopic management of incarcerated lung herniation after blunt chest trauma: a case report and literature review. J Thorac Dis 2017;9(3):E253–E257. DOI: 10.21037/jtd.2017.03.4
  10. Kuckelman J, Karmy-Jones R, Windell E, et al. Traumatic thoracic rib cage hernias: operative management and proposal for a new anatomic-based grading system. Am J Surg 2018;215(5):794–800. DOI: 10.1016/j.amjsurg.2017.12.013
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.