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Intercostal lung hernia

Case contributed by Dr Erik Ranschaert

Presentation:

IC-patient with persisting pain in chest, clinical suspicion of pulmonary embolism

Modality: X-ray
Modality: CT

Case Discussion:

Intercostal lung herniations are usually caused by a combination of increased intrathoracic pressure and a weakened chest wall. 

  • the cause is most frequently post-traumatic or iatrogenic (52%), 
  • COPD with emphysema is less frequently a causative factor (18%). 
  • in 30% of the cases herniations occur spontaneously (during weight lifting, glass blowing or trumpet playing...). 
  • congenital herniations are less frequent

Patients usually present with a local swelling of the chest wall, acute chest pain or a focal painful mass on the chest. 

A possible complication is incarceration or strangulation of pulmonary tissue, causing pain and haemoptysis. Treatment is surgical.

See article: Lung Hernia

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