Traumatic lung herniation

Excerpt

Traumatic lung herniation is a rare diagnosis, and literature on its optimal therapeutic management (i.e., medical vs surgical) is scarce. We present the case of a 53-yr-old man admitted to our trauma centre with blunt chest trauma after being crushed by the car he was repairing. An initial chest computed tomography (CT) scan on admission to the intensive care unit (ICU) revealed bilateral lung contusions, small hemopneumothorax, fractured sternum, and multiple bilateral rib fractures (with a left radiologically flail segment) associated with intense subcutaneous emphysema. As there was no clinically obvious flail segment with spontaneous ventilation, a conservative approach was used that included attempts to optimize analgesia, perform chest physiotherapy, and supply nasal high-flow oxygen therapy to improve the patient’s oxygenation and comfort. The small hemopneumothorax did not necessitate placement of a chest tube. …