Intercostal lung hernia

Last revised by Domenico Nicoletti on 10 Jun 2023

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. 

Intercostal lung herniations are considered the commonest form of lung herniation.

Patients can be asymptomatic or present with localized chest pain (latter especially in patients with prior thoracotomy or chest tube placements).

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.

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
  • entrapped lung can undergo strangulation and recurrent infection 3

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: left intercostal lung hernia
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  • Case 4: complicated by pneumonia
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  • Case 5
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  • Intercostal lung herniation
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