Post Traumatic Lung Herniation Case Studies
INTRODUCTION
Post-traumatic lung herniation can occur immediately after chest trauma or it may appear months or years after onset. CASE REPORT
A seventeen-year-old male patient presented with thoracic blunt trauma secondary to a high-energy bicycle accident. The chest CT showed moderate hemothorax, pneumothorax, a displaced fracture of the fifth left rib, and protusion of pulmonary tissue through the chest wall. The patient presented with chest pain (7/10 on the Visual Analog Scale) and shortness of breath.
A video-assisted thoracic surgery approach was performed. Hernia reduction, non-anatomic lingular resection, and rib fracture external fixation of the fifth rib was completed using a titanium plate.
DISCUSSION
Traumatic lung herniation …show more content…
In 1847, Morel-Lavallée (1) classified lung herniation into cervical, thoracic or diaphragmatic. Lung herniation can also be classified based on congenital or acquired etiology (traumatic, spontaneous or pathological cause).
Since Roland’s first case report in 1499 (2), approximately 300 cases have been reported in the international literature. 85% of lung herniation is caused by trauma (65% thoracic, 35% cervical and less than 1% diaphragmatic) (3). There are also spontaneous cases reported, which are mainly caused by valsalva maneuver (4) and pathological cases caused by infectious diseases such as tuberculosis (5).
Chest trauma may be caused by penetrating or blunt mechanisms. Blunt trauma is however more frequent in occurrence. If lung herniation has occurred, chest pain, dyspnea, subcutaneous emphysema, bone crepitation and hemoptysis (in case of damage of the lung parenchyma) may be …show more content…
Lung tissue reduction was performed. Due to the macroscopic appearance of ischemia and venous congestion of the involved lung tissue, a non-anatomic lingular resection using 60 mm Echelon Flex Stappler® was performed (Figure 3) as well as a chest washout. A longitudinal incision was made over the fractured rib (Figure 4). A displaced rib fracture was observed. Bone segments were reduced and fixed using a 6 cm titanium plate (STRATOStm System). A chest tube was inserted through the 7th ICS and connected to a closed water seal device on suction (Figure
Post-traumatic lung herniation can occur immediately after chest trauma or it may appear months or years after onset. CASE REPORT
A seventeen-year-old male patient presented with thoracic blunt trauma secondary to a high-energy bicycle accident. The chest CT showed moderate hemothorax, pneumothorax, a displaced fracture of the fifth left rib, and protusion of pulmonary tissue through the chest wall. The patient presented with chest pain (7/10 on the Visual Analog Scale) and shortness of breath.
A video-assisted thoracic surgery approach was performed. Hernia reduction, non-anatomic lingular resection, and rib fracture external fixation of the fifth rib was completed using a titanium plate.
DISCUSSION
Traumatic lung herniation …show more content…
In 1847, Morel-Lavallée (1) classified lung herniation into cervical, thoracic or diaphragmatic. Lung herniation can also be classified based on congenital or acquired etiology (traumatic, spontaneous or pathological cause).
Since Roland’s first case report in 1499 (2), approximately 300 cases have been reported in the international literature. 85% of lung herniation is caused by trauma (65% thoracic, 35% cervical and less than 1% diaphragmatic) (3). There are also spontaneous cases reported, which are mainly caused by valsalva maneuver (4) and pathological cases caused by infectious diseases such as tuberculosis (5).
Chest trauma may be caused by penetrating or blunt mechanisms. Blunt trauma is however more frequent in occurrence. If lung herniation has occurred, chest pain, dyspnea, subcutaneous emphysema, bone crepitation and hemoptysis (in case of damage of the lung parenchyma) may be …show more content…
Lung tissue reduction was performed. Due to the macroscopic appearance of ischemia and venous congestion of the involved lung tissue, a non-anatomic lingular resection using 60 mm Echelon Flex Stappler® was performed (Figure 3) as well as a chest washout. A longitudinal incision was made over the fractured rib (Figure 4). A displaced rib fracture was observed. Bone segments were reduced and fixed using a 6 cm titanium plate (STRATOStm System). A chest tube was inserted through the 7th ICS and connected to a closed water seal device on suction (Figure