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Ucgun A, Kurtulus Ozturk E, Ozturk S. Spontaneous Chest Wall Hernias: Intercostal Lung Hernia and Inverted Intercostal Hernia. Indian J Radiol Imaging 2024; 34:781-783. [PMID: 39318588 PMCID: PMC11419741 DOI: 10.1055/s-0044-1787840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Abstract
Intercostal lung hernia and inverted intercostal hernia are rare chest wall hernias usually asymptomatic and detected incidentally on chest radiograph. In this case report, we discussed here on the chest radiograph and computed tomography imaging findings of two cases of these rare hernias with an emphasis being in differential diagnosis of chest tumors.
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Affiliation(s)
- Aybuke Ucgun
- Department of Radiology, Ankara Etlik City Hospital, Ankara, Türkiye
| | | | - Saffet Ozturk
- Department of Radiology, Ankara Etlik City Hospital, Ankara, Türkiye
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2
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Leivaditis V, Grapatsas K, Papatriantafyllou A, Koletsis EN, Charokopos N, Dahm M. Surgical Repair of Spontaneous Lung Herniation Induced by Vigorous Coughing: A Case Report and Literature Review. Cureus 2023; 15:e37325. [PMID: 37182085 PMCID: PMC10168014 DOI: 10.7759/cureus.37325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Lung herniation is a rare clinical entity defined by extrathoracic protrusion of the lung or lung tissue due to a weakness in the thoracic wall. We present here a case of a 72-year-old male who presented with a spontaneous lung herniation, which occurred as a result of a ventral luxation of the third rib from the sternocostal joint due to vigorous coughing. The defect was repaired through anterolateral thoracotomy, reposition of the lung and approximating the ribs using heavy sutures. The postoperative course of the patient was uncomplicated. A brief review of the literature is also provided.
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Affiliation(s)
- Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, DEU
| | - Konstantinos Grapatsas
- Department of Thoracic Surgery and Thoracic Endoscopy, University Medicine Essen - Ruhrlandklinik, Essen, DEU
| | | | | | - Nikolaos Charokopos
- Department of Cardiothoracic Surgery, Patras University Hospital, Patras, GRC
| | - Manfred Dahm
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, DEU
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3
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Avila-Castano K, Garzon-Siatoya WT, Gonzalez-Estrada A. Spontaneous Combined Lung and Bowel Herniation Due to Uncontrolled Asthma. Cureus 2023; 15:e34939. [PMID: 36938229 PMCID: PMC10017090 DOI: 10.7759/cureus.34939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/15/2023] Open
Abstract
Spontaneous lung and bowel hernias are infrequent structural defects secondary to conditions that usually follow bouts of excessive straining. These two conditions have been individually well documented in the literature; however, there are seldom reports of this combination of defects. Here, we describe the case of a 69-year-old man diagnosed with combined spontaneous lung and colon herniation following an episode of severe coughing due to uncontrolled asthma. Early recognition and prompt treatment should be warranted to prevent complications.
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Affiliation(s)
- Karol Avila-Castano
- Division of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, USA
| | - Wendy T Garzon-Siatoya
- Division of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, USA
| | - Alexei Gonzalez-Estrada
- Division of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, USA
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Morales Borrero WJ, Madonado Vargas J. A 64-Year-Old Man with Traumatic Right Middle Lobe Lung Herniation Successfully Managed Conservatively. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931446. [PMID: 34145210 PMCID: PMC8218886 DOI: 10.12659/ajcr.931446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Patient: Male, 64-year-old Final Diagnosis: Right lung hernia • trauma Symptoms: Chest pain • shortness of breath Medication: — Clinical Procedure: Chest tube • conservative management Specialty: Thoracic Surgery • Radiology • Trauma Surgery
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Affiliation(s)
- Walter J Morales Borrero
- Section of Diagnostic Radiology, School of Medicine, University of Puerto Rico (UPR) Medical Sciences Campus, San Juan, Puerto Rico
| | - José Madonado Vargas
- Section of Diagnostic Radiology, School of Medicine, University of Puerto Rico (UPR) Medical Sciences Campus, San Juan, Puerto Rico
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5
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Mhamdi S, Aouini I, Daboussi S, Mahfoudhi H, Lassoued MB, Kallel M, Moetamri Z, Aichaouia C, Mejri I, Khadhraoui M, Cheikh R. Intercostal lung herniation secondary to thoracotomy: a case report. Pan Afr Med J 2020; 36:39. [PMID: 32774615 PMCID: PMC7388616 DOI: 10.11604/pamj.2020.36.39.20054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022] Open
Abstract
Intercostal lung herniation is defined as a protrusion of the lung parenchyma through a defect in the intercostal muscles between adjacent ribs. The authors report a case of intercostal pulmonary hernia in a 45-year-old male patient, with smoking habit (30 packs-year), presented to the emergency department with dyspnea. He had the history of pulmonary emphysema complicated with a total right pneumothorax in 2015 treated by mini-thoracotomy with bullectomy and pleural abrasion. In 2019, he was admitted to hospital for left chest pain. The computed tomography (CT) scan of the chest revealed a bilateral emphysema with intercostal lung hernia through the fourth intercostal space the patient underwent, a left thoracotomy with repair of the intercostal muscle defect. He was discharged from hospital free of complications.
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Affiliation(s)
- Samira Mhamdi
- Pulmonology Department, Military Hospital, Tunis, Tunisia
| | - Ines Aouini
- Pulmonology Department, Military Hospital, Tunis, Tunisia
| | | | | | | | - Manel Kallel
- Emergency Department, Military Hospital, Tunis, Tunisia
| | - Zied Moetamri
- Pulmonology Department, Military Hospital, Tunis, Tunisia
| | | | - Islem Mejri
- Pulmonology Department, Military Hospital, Tunis, Tunisia
| | | | - Rzaieg Cheikh
- Pulmonology Department, Military Hospital, Tunis, Tunisia
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6
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Lee MN, Surry LT, Ferraro DM. Aggravation and deliberation over lung herniation. BMJ Case Rep 2019; 12:12/5/e229225. [PMID: 31138594 DOI: 10.1136/bcr-2019-229225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A Caucasian woman aged 58 years with history of asthma and surgically repaired congenital diaphragmatic hernia presented to the emergency department (ED) with persistent cough, pleuritic chest pain, shortness of breath, in spite of recent treatment for influenza A virus. On physical examination, a large bulge was protruding from her left posterior thorax. She was found to have a large abnormal radiographic lucency on lateral chest X-ray posterior to the thoracic cavity, confirmed with chest CT to represent a large lung herniation in between the left seventh and eighth ribs. The patient was evaluated by a thoracic surgeon and offered surgical repair but ultimately decided on conservative management which to date has been ineffective.
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Affiliation(s)
- Michelle N Lee
- Internal Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, Texas, USA
| | - Luke T Surry
- Internal Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, Texas, USA
| | - David M Ferraro
- Pulmonary & Critical Care, US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA
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Chaturvedi A, Rajiah P, Croake A, Saboo S, Chaturvedi A. Imaging of thoracic hernias: types and complications. Insights Imaging 2018; 9:989-1005. [PMID: 30484078 PMCID: PMC6269341 DOI: 10.1007/s13244-018-0670-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/06/2018] [Accepted: 10/18/2018] [Indexed: 12/23/2022] Open
Abstract
Thoracic hernias are characterised by either protrusion of the thoracic contents outside their normal anatomical confines or extension of the abdominal contents within the thorax. Thoracic hernias can be either congenital or acquired in aetiology. They can occur at the level of the thoracic inlet, chest wall or diaphragm. Thoracic hernias can be symptomatic or fortuitously discovered on imaging obtained for other indications. Complications of thoracic hernias include incarceration, trauma and strangulation with necrosis. Multiple imaging modalities are available to evaluate thoracic hernias. Radiographs usually offer the first clue to the diagnosis. Upper gastrointestinal radiography can identify bowel herniation and associated complications. CT and occasionally MR can be useful for further evaluation of these abnormalities, accurately identifying the type of hernia, its contents, associated complications, and provide a roadmap for surgical planning. In this article, we review the different types of thoracic hernias and the role of imaging in the evaluation of these hernias. TEACHING POINTS: • Protrusion of lung contents beyond the anatomic confines of the thorax constitutes a hernia. • Complications of thoracic hernias include incarceration, trauma and strangulation with necrosis. • Multiple imaging modalities are available to evaluate thoracic hernias. • CT is the imaging modality of choice for identifying thoracic hernias and their complications. • Imaging can provide a roadmap for surgical planning.
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Affiliation(s)
- Abhishek Chaturvedi
- Imaging Science, University of Rochester Medical Center, 601, Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Prabhakar Rajiah
- Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexender Croake
- Imaging Science, University of Rochester Medical Center, 601, Elmwood Avenue, Rochester, NY, 14642, USA
| | - Sachin Saboo
- Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Apeksha Chaturvedi
- Imaging Science, University of Rochester Medical Center, 601, Elmwood Avenue, Rochester, NY, 14642, USA
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Abstract
Spinal cord compression by structures adjacent to the spine is a rare event. The authors present a case of spinal cord compression in an adult caused by a partial herniated lung after a traffic accident. No similar cases were found in the literature.
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Ema T, Funai K, Kawase A, Oiwa H, Iizuka S, Shiiya N. Incarceration hernia of the lung after video-assisted thoracic surgery requiring emergency operation: a case report. J Thorac Dis 2018; 10:E541-E543. [PMID: 30174929 DOI: 10.21037/jtd.2018.06.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Toshinari Ema
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Akikazu Kawase
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Hiroaki Oiwa
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Shuhei Iizuka
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan
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Romero C, Varon DS, Surani S, Varon J. Thoracic herniation secondary to pleural effusion. Respir Med Case Rep 2018; 23:96-97. [PMID: 29487789 PMCID: PMC5805847 DOI: 10.1016/j.rmcr.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 02/05/2023] Open
Abstract
We present the case of a 61-year-old gentleman with history of stage IV esophageal cancer presented to the emergency department with the complaints of dyspnea on exertion and cough of 1-month duration. Patient had undergone resection of distal esophagus 4 years' prior this admission. Chest radiograph revealed a large right pleural effusion and, a computed tomography scan of the chest revealed a portion of the effusion herniating between the ribs in the right hemithorax. Thoracentesis was performed with improvement in patient's dyspnea and overall condition. Patient was doing better and asymptomatic on his 3-month follow-up. Inadequate closure after surgical procedure can lead to presentation of a lung herniation. This can appear immediately after or many years later. Video-assisted thoracoscopy has been attributed to post-operative presentation of thoracic hernias when compared to more extensive operative procedures.
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Affiliation(s)
- Carlos Romero
- Dorrington Medical Associates, Houston, TX, USA
- Universidad Autónoma de San Luis Potosi, San Luis Potosi, Mexico
| | - Daryelle S. Varon
- Dorrington Medical Associates, Houston, TX, USA
- St. James School of Medicine, British West Indies, Anguilla
| | | | - Joseph Varon
- The University of Texas Health Science Center at Houston, Clinical Professor of Medicine, The University of Texas Medical Branch at Galveston, Chief of Critical Care Services, United Memorial Medical Center, Houston, TX, USA
- Corresponding author. 2219 Dorrington Street Houston, Texas 77030, USA.
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Puah SH, Tan Pei Sze C, Abisheganaden J. Lung herniation after positive pressure ventilation. Respir Med Case Rep 2016; 20:61-63. [PMID: 28053853 PMCID: PMC5198735 DOI: 10.1016/j.rmcr.2016.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/16/2016] [Indexed: 11/02/2022] Open
Abstract
Lung herniation is a rare condition which has only been mainly published as case reports in the literature. Although its description has been around since 1845, not much is still known about it. More often seen after trauma or as a surgical complication post thoracic surgery, it's management usually depends on its etiology and varies between individuals. We report a case of lung herniation after positive pressure ventilation from a previous thoracotomy site. To our knowledge, this is the first report where the lung herniation was precipitated by mechanical ventilation.
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Affiliation(s)
- Ser Hon Puah
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Carmen Tan Pei Sze
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - John Abisheganaden
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore
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12
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Delayed Presentation of a Traumatic Intercostal Lung Hernia: A Case Report and Review of the Literature. Trauma Mon 2016. [DOI: 10.5812/traumamon.25975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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