Chest
Volume 64, Issue 2, August 1973, Pages 254-256
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Spontaneous Lung Hernia

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CASE REPORT

A 58-year-old foundry man felt sudden sharp excruciating pain in the right side of the chest following clockwise rotation of his body. He subsequently developed right upper abdominal pain and coughing spells.

Physical examination revealed a very obese, 250 lb white man with a blood pressure of 120/80 mm Hg and pulse rate of 100/min. Ecchymosis and erythema were noted in the right lower chest and upper abdomen, anteriorly. A crepitant mass 8 × 6 cm, was palpable at the right seventh intercostal

COMMENT

The development of the spontaneous lung hernia involves two factors: firstly, a weakness in the thoracic wall or boundaries of the chest cavity usually occurs in the chest wall anteriorly from the costochondral junction to the sternum because of the absence of the external intercostal muscle, posteriorly from the costal angle to the vertebrae because of the absence of the internal intercostal muscle and superiorly in the cervical area from deficiency of Sibson's fascia, parietal pleura or neck

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    The defect was repaired surgically by approximation of the eighth and ninth ribs with wires. Lung herniation is an uncommon entity and can be a result of a traumatic, spontaneous, or pathologic cause.1-3 Traumatic hernias may appear immediately after injury or be delayed for years.4

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