Chest
Volume 107, Issue 3, March 1995, Pages 877-879
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Selected Reports: Articles
Lung Herniation: A Cause of Chronic Chest Pain Following Thoracotomy

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Chronic chest pain is a common complication following thoracotomy, which is generally attributed to intercostal neuritis or neuralgia. Response to medical treatment is poor. We report a case of persistent chest pain following open lung biopsy, which was found to result from lung herniation, a rare, but surgically correctable complication of thoracotomy. Since lung herniation may be easily overlooked, this disorder should be considered more often in the differential diagnosis of persistent postthoracotomy chest pain.

Section snippets

Case Report

A 48-year-old man with a medical history of mild chronic obstructive pulmonary disease and coronary artery bypass graft surgery in 1988 was admitted to the hospital for treatment of bilateral pneumonia. Initial therapy included intravenous cefuroxime and erythromycin. All cultures, including sputum, urine, and blood, were negative. Antibodies to HIV were not detectable. Despite treatment, the patient required intubation and mechanical ventilation for worsening respiratory failure. An open lung

Discussion

Persistent postthoracotomy chest pain following thoracic surgical procedures has been generally attributed to intercostal neuritis or neuralgia.1 Although the actual incidence is uncertain, such chronic chest pain is believed to occur in only 1 to 3% of patients, based on anecdotal reports.2 However, Dajczman et al1 recently assessed the frequency of chronic postthoracotomy chest pain in 56 patients. In their series, 55% of patients had persistent chest pain lasting more than 1 year following

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