The Teaching Point

In cases of intercostal lung herniation chest CT using multiplanar reconstructions (MPR) and maximum (MIP) and minimum intensity projection images (minIP) can clearly confirm the existence, the extent and condition of herniated lung tissue, while volume rendering reconstructions (VRT) may be helpful for surgical planning.






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Intercostal lung herniation - The role of imaging

Free full text article: Intercostal lung herniation - The role of imaging

Abstract
Extrathoracic lung hernias can be congenital or acquired. Acquired hernias may be classified by etiology into traumatic, spontaneous, and pathologic. We present a case of a 40-year-old male with a history of bronchial asthma and a blunt chest trauma who presented complaining of sharp chest pain of acute onset that began after five consecutive days of vigorous coughing. Upon physical examination a well-demarcated deformity overlying the third intercostal space of the left upper anterior hemithorax was revealed. Thoracic CT scan showed that a portion of the anterior bronchopulmonary segment of the left upper lobe had herniated through a chest wall defect. The role of imaging, especially chest computed tomography with multiplanar image reconstructions and maximum (MIP) and minimum intensity projection (MinIP) reformats can clearly confirm the presence of the herniated lung, the hernial sac, the hernial orifice in the chest wall, and exclude possible complications such as lung tissue strangulation.






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