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Traumatic intercostal pulmonary hernia
1Department of Surgery, Papworth Hospital, Papworth Everard, Cambridgeshire, England.
Insights
Traumatic intercostal pulmonary hernia in children may resolve spontaneously, but surgical repair with a Gore-Tex patch is effective for persistent cases. This rare injury requires careful management consideration.
Area of Science:
- Pediatric surgery
- Thoracic trauma
- Medical device technology
Background:
- Traumatic intercostal pulmonary hernia is a rare consequence of chest injury, particularly in pediatric patients.
- Non-penetrating injuries can also lead to this condition, complicating diagnosis and management.
- Previous reports suggest spontaneous regression and conservative treatment are viable options.
Observation:
- A pediatric case presented with a persistent intercostal defect and lung hernia that did not regress.
- The defect had smooth, non-proliferative walls, differing from typical traumatic hernias.
- Conservative management was initially considered but deemed unsuitable due to lack of resolution.
Findings:
- Successful surgical repair was achieved using a Gore-Tex (expanded polytetrafluoroethylene) patch.
- The patch provided a durable and effective closure for the intercostal defect.
- Histological examination of the defect is pending but initial observations suggest a unique presentation.
Implications:
- Surgical intervention is a recommended treatment for pediatric intercostal pulmonary hernias that do not resolve spontaneously.
- Gore-Tex patching offers a reliable method for repairing these rare thoracic defects.
- Delayed surgical intervention may be considered to allow for potential spontaneous resolution in select cases.
Abstract:
Traumatic intercostal pulmonary hernia is a rare sequel to injury, especially in children and where there is no penetrating wound. Spontaneous regression of these hernias has been reported and conservative management has been advocated. We describe a case in which a smooth-walled intercostal defect and lung hernia that did not regress developed in a child. This was successfully repaired with a Gore-Tex (expanded polytetrafluoroethylene) patch. Repair is advisable in such cases, but operation can be delayed to allow possible resolution.