Complicated spontaneous intercostal lung hernia - A rare clinical case

Abstract

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 9th 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.

Spontaneous pulmonary herniation in COVID‐19

“…Most lung hernias occur in the context of trauma or post‐operatively. Spontaneous pulmonary hernias, without antecedent trauma or surgery, make up approximately 30% of cases 7 …”

“…Spontaneous pulmonary hernias, without antecedent trauma or surgery, make up approximately 30% of cases. 7 Spontaneous pulmonary hernias due to coughing occur owing to dramatically increased intrathoracic pressure causing damage to the chest wall. Risk factors include male gender, obstructive airways disease (COPD/asthma), smoking status, steroid use and obesity.…”

“…Spontaneous pulmonary hernias, without antecedent trauma or surgery, make up approximately 30% of cases. 7 …”

Surgical Repair of Spontaneous Lung Herniation Induced by Vigorous Coughing: A Case Report and Literature Review

“…As mentioned before, increasingly more cases of spontaneous lung hernias have been reported in the literature during the last decade [ 1 , 2 , 7 , 11 , 16 - 19 ]. Ugolini et al reported five patients, all of which were males with a median age of 68 years [ 2 ].…”

A patient with a pulmonary hernia and chance fracture of the thoracic vertebra following a fall: A case report and literature review

“…Generally, a simple thoracic wall defect is not sufficient to cause pulmonary herniation, and most patients have other exacerbating factors like a sudden increase in intrathoracic pressure, unhealed hernias, etc. Other high-risk factors include diabetes, obesity, smoking, chronic obstructive pulmonary disease (COPD), and long-term steroid use [ 7 , 8 ]. According to the classical Morel Lavelle method, pulmonary hernias can either be congenital (18 %) or acquired (82 %) [ 9 ].…”