An intercostal lung hernia is a form of lung herniation and is defined as a protrusion of pulmonary tissue and pleural membranes beyond the confines of the thoracic cavity through a defect/opening in the chest wall.
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Epidemiology
Intercostal lung herniations are considered the commonest form of lung herniation.
Clinical presentation
Patients can be asymptomatic or present with localized chest pain (latter especially in patients with prior thoracotomy or chest tube placements).
Pathology
They may be congenital or acquired. Most acquired lung hernias result from blunt or penetrating chest wall trauma, or from a preceding operative procedure with inadequate closure of herniated lung 2.
Location
In congenital cases, there may be a predilection towards sites in the thoracic cage that have inherent weaknesses such as
- anteriorly: near the sternum, medial to the costochondral junction, and
- posteriorly: near the vertebral bodies, where there is a single layer of intercostal muscle
Complications
- entrapped lung can undergo strangulation and recurrent infection 3
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