Spontaneous intercostal lung herniation complicated by rib fractures: a therapeutic dilemma

Complicated spontaneous intercostal lung hernia - A rare clinical case

Spontaneous lung herniation is a rare pathological entity. We present a case of intercostal type of spontaneous lung hernia after heavy lifting complicated with huge soft tissue hematoma, single rib fracture, hemothorax, diaphragmatic laceration, and great omentum pleural cavity herniation in a 46-year-old man. His comorbidities were arterial hypertension, congestive heart failure, and type II diabetes mellitus and had no history of trauma, surgical procedures in his thoracic wall, or chronic obstructive pulmonary disease. Physical examination revealed a huge left-sided flank hematoma. Chest X-ray determined stable intercostal lung hernia confirmed by chest computed tomography. Conventional approach by left mid-lateral thoracotomy was used for surgical repair of the lung hernia and stabilization of the intercostal space. The patient was discharged on the 9^th postoperative day in a good condition. Control examination 2 years after the operation found no deformation of the thorax or recurrence of the lung hernia. This is a case of interest of spontaneous intercostal lung hernia because of the number and type of associated injuries. This case demonstrates low morbidity and good postoperative result by conventional surgery in intercostal lung hernias.

Anterior Lung Evisceration Following an Assault with Knife: A Case Report

Introduction

Evisceration of the lung is a rare consequence of open chest trauma that can be fatal. Evisceration of the lung refers to the protrusion of lung parenchyma through a defect of the thoracic wall, without parietal pleural or skin coverage.

Case report

A 20-year-old man was brought to the emergency department (ED) with left lung evisceration from stab wounds. The eviscerated lung was left in place, and the patient was not intubated in the ED. He was immediately taken to the operating room (OR) for intubation and surgical repair. Other significant injuries were ruled out, the eviscerated lung was retrieved, the chest wall defect was closed, and the patient recovered well. He was discharged after seven days in good condition.

Conclusion

The initial management of patients with lung evisceration is critical to prevent rapid decompensation and death. Appropriate ED airway management, lung retrieval in the OR, and thoracic wall repair is recommended for patients with lung evisceration.

Spontaneous Lung Herniation Through the Chest Wall

A 71-yr-old male with a medical history significant for chronic obstructive pulmonary disease presented to emergency department for worsening cough, right-sided pleuritic chest pain, and dyspnea. This was the patient's third visit to the emergency department in 4 d. The patient was initially treated for chronic obstructive pulmonary disease exacerbation and subsequently evaluated for congestive heart failure. He was ultimately diagnosed with a spontaneous herniation of the lung parenchyma through the chest wall. The patient was transferred to an outside host nation facility for definitive treatment and repair of the chest wall defect. Refractory cough and dyspnea failing to respond to typical treatments should warrant an expanded differential to include the rare etiology of atraumatic spontaneous lung herniation.

Cough-induced nonunion rib fractures and herniation: surgical repair and review

We present the case of a 57-year-old man who had suffered pain in the left hemithorax for a year, which started after a period of severe coughing during pneumonia. The pain was triggered by lying down. A computed tomography scan revealed two nonunion costal fractures. In the operating room, intercostal diastasis with pulmonary herniation was encountered in addition to the costal fractures. This report describes the technique used to reconstruct the thoracic wall with mesh and plate-osteosynthesis.

Thoracoscopic management of incarcerated lung herniation after blunt chest trauma: a case report and literature review

Traumatic lung herniation is a rare condition that is usually treated with thoracotomy and pericostal fixation of adjacent ribs with sutures. We described a traumatic lung herniation case successfully managed with hernia reduction and double-layered repair of the intrathoracic defect, completed via a total thoracoscopic approach.

Traumatic Lung Herniation following Skateboard Fall

Lung herniation (LH) is a rare clinical entity involving the protrusion of lung outside the thoracic cage. It has a variety of etiologies and clinical presentations, making diagnosis difficult. We present a case of a 20-year-old male who reported pleuritic pain after falling from a skateboard. Evaluation through computed tomography (CT) scanning of the chest revealed an anterior lung hernia associated with rib fractures. This case emphasizes the need for clinicians to include lung herniation in the differential diagnosis of patients with trauma and inexplicable or persistent pulmonary issues.