Isolated congenital inter-costal pulmonary hernia: a case report

Abstract

Background Intercostal lung herniation is a rare condition that may be congenital (20%) or acquired (80%). The isolated congenital form is exceptional, with one case reported in the literature. Case presentation We report a case of a 10-year-old French boy of Algeria origin, born with intermittent swelling of his right hemithorax. The swelling and pain gradually increased with age. A clinical examination revealed a localized swelling of his right hemithorax at the level of the midclavicular line and the fifth intercostal space. The swelling increased in size during respiratory movements and enlarged with Valsalva maneuvers. The intercostal lung hernia was treated by thoracoscopy. Conclusions This is the second case of isolated congenital intercostal pulmonary hernia reported in the French and English literature. It is the first to be treated by thoracoscopy. Based on this case we performed a review of the diagnosis and therapeutic aspect of pulmonary hernias. Electronic supplementary material The online version of this article (10.1186/s13256-019-2142-4) contains supplementary material, which is available to authorized users.

Bilateral Intercostal Lung Herniations: A Rare Incidental Finding in a Dyspneic Patient

“…Intercostal herniations are classified as congenital (18%), acquiredtraumatic (52%), or acquired-spontaneous (30%). 1,2 These can develop due to increased intrathoracic pressure with concurrent weaknesses in the chest wall. 3 Symptoms include pain with inhalation, coughing, or sneezing; shortness of breath; soreness; or swelling.…”

“…Long-term complications of lung hernias include recurrent pulmonary infections and strangulation. 2 Few cases of bilateral thoracic lung herniations are documented in the literature. 4 Repair is often indicated in cases with pain and entrapped lung.…”

Hérnia pulmonar intercostal: relato de caso e revisão de literatura

“…Segundo a etiologia, dividem-se em congênitas ou adquiridas 8 . As hérnias congênitas são mais raras, correspondendo a 20% dos casos, enquanto as adquiridas representam 80% das hérnias pulmonares 9 . As hérnias adquiridas subdividem-se, ainda, em espontânea, patológica (secundária a neoplasias ou doenças inflamatórias), pós-cirúrgica ou pós-traumáticas.…”

“…As hérnias congênitas frequentemente estão associadas a uma alteração subjacente na parede torácica e são resultantes de um defeito na fáscia de Sibson 9,12 . Existem apenas dois relatos na literatura de hérnia pulmonar congênita isolada 9 .…”

“…O tratamento ainda é controverso, uma vez que a literatura carece de estudos com elevado nível de evidência científica, em grande parte decorrente da raridade desta entidade clínica e motivo pelo qual é importante descrever relatos de manejo exitoso de hérnias intercostais 9,12 .…”