Spontaneous pulmonary hernia secondary to intercostal muscle tear

• Published in: BMJ case reports Vol. 12; no. 10; p. e231706
• Main Authors: O" Mahony, Anne M, Murphy, Kevin M, O"Connor, Terence M, Curran, David R
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01-10-2019; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Asthma; Case reports; Cough - complications; Defects; Diagnosis, Differential; Hernia - diagnostic imaging; Hernia - drug therapy; Hernia - etiology; Hernias; Humans; Images In; Intercostal Muscles - diagnostic imaging; Intercostal Muscles - injuries; Lung Diseases - diagnostic imaging; Lung Diseases - drug therapy; Lung Diseases - etiology; Male; Nebulizers and Vaporizers; Pain; respiratory medicine; Steroids - therapeutic use; Tomography Scanners, X-Ray Computed; Ultrasonic imaging; ultrasonography; United States > US; respiratory medicine; ultrasonography
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2019-231706

The role for surgical repair is controversial, but indications for surgical intervention include increasing size, refractory pain or incarceration.3 However, the majority of cases follow a benign course and can be managed conservatively. A 65-year-old man with a history of asthma presented with a 1-week history of cough productive of purulent sputum, increasing dyspnoea and wheeze. CT of thorax with contrast demonstrating widening posterolaterally of the intercostal space between the left eighth and ninth ribs at the costophrenic angle and herniation of the pleura and lung between the ribs on axial views (A,B, asterisk) and into the chest wall, deep to the oblique muscles, serratus anterior and latissimus dorsi on coronal views (C,D, asterisk).