Case of intercostal lung hernia with hemosputum that developed after thoracoscopic lobectomy

THE FIRST EXPERIENCE OF THORACOSCOPIC HERNIOPLASTY FOR INTERCOSTAL PULMONARY HERNIA (CLINICAL OBSERVATION AND LITERATURE REVIEW)

A pulmonary hernia is a protrusion of the lung through a defect in the surrounding tissues, a rather rare pathology and each clinical case is of scientific interest. The first description of this rare pathology was performed by Roland in 1499. About 300 observations have been described in the world literature, most of the publications are isolated cases of observation of this pathology. We have presented the first experience of thoracoscopic hernioplasty in the Russian Federation for intercostal pulmonary hernia, and also summarized the literature data on this topic.

A serious fit of cough: A 66-year-old patient with myasthenia gravis presenting with spontaneous intercostal lung herniation after coughing. Case report and pathophysiological discussion

We present a case of a 66-year-old man with history of myasthenia gravis, severe obesity and osteopenia self-presented to our Emergency Department (ED) with severe pain in his left hemithorax, occurred after an episode of cough three days before. No history of trauma was reported. The patient underwent a chest-XR showing uncomplicated spontaneous fractures of the 5th and 6th left ribs. He was therefore discharged with appropriate analgesic treatment. Five days later, the patient came back to our ED for a wide left abdominal hematoma, though hemodynamically stable and eupneic. A CT-scan with contrast showed a rare and unexpected spontaneous left intercostal lung herniation complicated with a diffuse subcutaneous emphysema, pneumothorax, loculated bilateral pleural effusion and abdominal hematoma. The patient was admitted, treated conservatively and safely discharged after two weeks. We also provide a pathophysiological discussion of the case and a literature review.