Elsevier

The Annals of Thoracic Surgery

Volume 74, Issue 6, December 2002, Pages 1963-1966
The Annals of Thoracic Surgery

Original article: general thoracic
Hernia of the lung

https://doi.org/10.1016/S0003-4975(02)04077-8Get rights and content

Abstract

Background

Lung hernia is uncommon and methods of management vary. During the past 17 years, we have seen 8 patients with this condition.

Methods

Between 1984 and 2000, 8 patients with lung hernias were seen on our service. Three hernias were caused by a thoracic operation, one was due to chronic cough, and in four, the hernia was congenital, with delayed presentation.

Results

Three patients had minimal symptoms and were not operated on. Closure of chest wall in the other patients was accomplished by suture approximation of ribs in 4 patients and by polypropylene mesh in 1 patient. There were no recurrences, and these patients remain asymptomatic.

Conclusions

Intercostal hernias are usually symptomatic and should be treated by operative closure. In supraclavicular hernias, the symptoms are usually minimal and complications are unlikely. These hernias can be left untreated, but the patients should be followed.

Section snippets

Patients and methods

During the years 1984 to 2000, 8 patients with lung hernia were seen at the Wolfson Medical Center (Table 1). There were three male and five female patients, ranging in age from 25 to 73 years. All patients were symptomatic. Four complained of pain. Bulge was present in seven instances; in 3 patients it was present most of the time regardless of straining, whereas in 4 patients, it was elicited by straining only. In 1 patient, the bulge was not present, but the chest defect was palpated. The

Results

All patients remain under follow-up (Table 2). Three patients who were not operated on (1, 4, and 8) remain under observation. There was no progress of their disease and their symptoms remain minimal. Four patients with intercostal hernia (2, 3, 6, and 7) treated by placing intercostal sutures, are well, with follow-up ranging from 2 to 16 years. The patient treated with Marlex mesh closure (patient 5) is well 1 year, 5 months after the operation. There were no complications related to the

Comment

Lung hernia is a rare condition. It was first described by Roland (cited in [3]). Since then approximately 300 patients have been reported 1, 2. In the majority of reported patients, the lung herniated through the intercostal space as a result of trauma or after thoracic operation; most of the other hernias were congenital. The most widely accepted classification of lung hernia is that of Morel-Lavallee [4], based on both the etiology and anatomic location. Classification by etiology recognizes

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