Lung Herniation Following Blunt Thoracic Trauma

Background

Lung incarceration is a potentially debilitating and life-threatening condition. It occurs when lung parenchyma becomes caught outside of the thoracic cavity, often associated with a chest wall defect. There are multiple etiologies for this condition, most of which require surgical intervention. Traumatic chest wall disruption is the most common cause of pulmonary herniation. There is little consensus on standard operative therapy.

Summary

We present the case of a 59-year-old male who sustained a traumatic pulmonary hernia following a motor vehicle collision. He presented in a delayed fashion with increasing chest discomfort and coughing. On CT, he was found to have multiple right-sided rib fractures and an incarcerated lung. He was taken to the operating room for a right thoracotomy. The hernia was surgically reduced, and internal fixation (ORIF) of ribs was performed. He tolerated surgery well and recovered uneventfully.

Conclusion

Management of pulmonary herniation is dependent on patient symptoms and characteristics of the chest wall defect. A variety of strategies may be employed with favorable patient outcomes.