Novakov Ivan Petkov, Hadzhiminev Velizar Dafinov, Timonov Pavel Todorov
Department of Special Surgery, Medical Faculty, Medical University, Plovdiv, Bulgaria.
Department of Forensic Medicine, Medical Faculty, Medical University, Plovdiv, Bulgaria.
Turk J Emerg Med. 2021 Oct 29;21(4):221-224. doi: 10.4103/2452-2473.329628. eCollection 2021 Oct-Dec.
Spontaneous lung herniation is a rare pathological entity. We present a case of intercostal type of spontaneous lung hernia after heavy lifting complicated with huge soft tissue hematoma, single rib fracture, hemothorax, diaphragmatic laceration, and great omentum pleural cavity herniation in a 46-year-old man. His comorbidities were arterial hypertension, congestive heart failure, and type II diabetes mellitus and had no history of trauma, surgical procedures in his thoracic wall, or chronic obstructive pulmonary disease. Physical examination revealed a huge left-sided flank hematoma. Chest X-ray determined stable intercostal lung hernia confirmed by chest computed tomography. Conventional approach by left mid-lateral thoracotomy was used for surgical repair of the lung hernia and stabilization of the intercostal space. The patient was discharged on the 9 postoperative day in a good condition. Control examination 2 years after the operation found no deformation of the thorax or recurrence of the lung hernia. This is a case of interest of spontaneous intercostal lung hernia because of the number and type of associated injuries. This case demonstrates low morbidity and good postoperative result by conventional surgery in intercostal lung hernias.
自发性肺疝是一种罕见的病理实体。我们报告一例46岁男性在重物搬运后发生肋间型自发性肺疝，并发巨大软组织血肿、单根肋骨骨折、血胸、膈肌裂伤和大网膜胸腔疝。他的合并症有动脉高血压、充血性心力衰竭和II型糖尿病，且无创伤史、胸壁手术史或慢性阻塞性肺疾病史。体格检查发现左侧胁腹有巨大血肿。胸部X线检查确定为稳定的肋间肺疝，胸部计算机断层扫描予以证实。采用左外侧开胸的传统方法对肺疝进行手术修复并稳定肋间间隙。患者术后第9天状况良好出院。术后2年的对照检查未发现胸廓变形或肺疝复发。由于相关损伤的数量和类型，这是一例值得关注的自发性肋间肺疝病例。该病例表明，传统手术治疗肋间肺疝的发病率低且术后效果良好。
