Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery
Lung hernia, the protrusion of pulmonary tissue outside of the thoracic cage, is a rare radiologic finding. The exact incidence of this condition is not well documented. The etiology is either secondary to underlying congenital conditions which weaken the supporting structures of the thoracic wall o...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2022-03-01
|
Series: | Radiology Case Reports |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043321008773 |
_version_ | 1819279205293096960 |
---|---|
author | Amanda L. Rugg, BS Jason J. Lee, MD |
author_facet | Amanda L. Rugg, BS Jason J. Lee, MD |
author_sort | Amanda L. Rugg, BS |
collection | DOAJ |
description | Lung hernia, the protrusion of pulmonary tissue outside of the thoracic cage, is a rare radiologic finding. The exact incidence of this condition is not well documented. The etiology is either secondary to underlying congenital conditions which weaken the supporting structures of the thoracic wall or more commonly, post-surgical changes. In this report, we describe the case of a 58-year-old male trauma patient who was involved in a motor vehicle collision. Computed tomography of the head, neck, body, and upper extremities was negative for acute injury, but an incidental left-sided herniation of the lingula between the fifth and sixth intercostal spaces was identified. Computed tomography is superior for identifying imaging lung herniations as chest radiographs may not visualize the defect. Upon further investigation, the patient had a remote history of pneumonia complicated by empyema treated by video-assisted thoracoscopic surgery (VATS). This history, coupled with the absence of traumatic injury to the thorax as well as the presence of pulmonary scarring suggests that the lung herniation was likely chronic and secondary to the VATS procedure. The patient was discharged home without surgical intervention. Asymptomatic lung herniations are typically managed conservatively, but patients and physicians should be aware of the risk of lung hernia after VATS as well as associated complications including strangulation or pulmonary infarct. |
first_indexed | 2024-12-24T00:24:12Z |
format | Article |
id | doaj.art-a286c2a3bae34ed7bded488096d232d6 |
institution | Directory Open Access Journal |
issn | 1930-0433 |
language | English |
last_indexed | 2024-12-24T00:24:12Z |
publishDate | 2022-03-01 |
publisher | Elsevier |
record_format | Article |
series | Radiology Case Reports |
spelling | doaj.art-a286c2a3bae34ed7bded488096d232d62022-12-21T17:24:30ZengElsevierRadiology Case Reports1930-04332022-03-01173798801Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgeryAmanda L. Rugg, BS0Jason J. Lee, MD1University of Arizona College of Medicine, Department of Medical Imaging, 1501 N. Campbell Ave, P.O. Box 245067, Tucson, AZ 85724, USACorresponding author.; University of Arizona College of Medicine, Department of Medical Imaging, 1501 N. Campbell Ave, P.O. Box 245067, Tucson, AZ 85724, USALung hernia, the protrusion of pulmonary tissue outside of the thoracic cage, is a rare radiologic finding. The exact incidence of this condition is not well documented. The etiology is either secondary to underlying congenital conditions which weaken the supporting structures of the thoracic wall or more commonly, post-surgical changes. In this report, we describe the case of a 58-year-old male trauma patient who was involved in a motor vehicle collision. Computed tomography of the head, neck, body, and upper extremities was negative for acute injury, but an incidental left-sided herniation of the lingula between the fifth and sixth intercostal spaces was identified. Computed tomography is superior for identifying imaging lung herniations as chest radiographs may not visualize the defect. Upon further investigation, the patient had a remote history of pneumonia complicated by empyema treated by video-assisted thoracoscopic surgery (VATS). This history, coupled with the absence of traumatic injury to the thorax as well as the presence of pulmonary scarring suggests that the lung herniation was likely chronic and secondary to the VATS procedure. The patient was discharged home without surgical intervention. Asymptomatic lung herniations are typically managed conservatively, but patients and physicians should be aware of the risk of lung hernia after VATS as well as associated complications including strangulation or pulmonary infarct.http://www.sciencedirect.com/science/article/pii/S1930043321008773Lung herniationVideo-assisted thoracoscopic surgeryLingulaIntercostalTrauma |
spellingShingle | Amanda L. Rugg, BS Jason J. Lee, MD Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery Radiology Case Reports Lung herniation Video-assisted thoracoscopic surgery Lingula Intercostal Trauma |
title | Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery |
title_full | Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery |
title_fullStr | Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery |
title_full_unstemmed | Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery |
title_short | Incidental finding of lung hernia in a patient with a remote history of empyema status post video-assisted thoracoscopic surgery |
title_sort | incidental finding of lung hernia in a patient with a remote history of empyema status post video assisted thoracoscopic surgery |
topic | Lung herniation Video-assisted thoracoscopic surgery Lingula Intercostal Trauma |
url | http://www.sciencedirect.com/science/article/pii/S1930043321008773 |
work_keys_str_mv | AT amandalruggbs incidentalfindingoflungherniainapatientwitharemotehistoryofempyemastatuspostvideoassistedthoracoscopicsurgery AT jasonjleemd incidentalfindingoflungherniainapatientwitharemotehistoryofempyemastatuspostvideoassistedthoracoscopicsurgery |