Pulmonary Hernia with Rib Fracture after Cough: CT Diagnosis

Abstract

The authors report a case of a 90-year-old male patient who presented with chest pain and bulging of the right chest wall after an intense coughing crisis. At physical examination, the bulging increased during expiration. The initial radiographic study did not reveal any significant change. Due to persistence of symptoms, Computed Tomography (CT) scan was performed, which revealed fracture of posterior 8th right rib and pleural effusion. As a result, a hernia of the right lung lower lobe secondarily developed, through the 8th enlarged right intercostal space. Based on this case, authors review etiological and pathophysiological aspects related to pulmonary hernias, highlighting the role of imaging methods in the diagnosis, as this condition may be clinically underestimated.