Through the Gap: A Rare Case of Intercostal Lung Hernia

Intercostal lung hernia is a rare condition characterized by the protrusion of lung tissue through a defect in the intercostal muscles or thoracic wall. It can be congenital or arise secondary to trauma or surgery or can be a spontaneous rupture due to elevated intrathoracic pressure. Given its rarity, intercostal lung hernia can present a diagnostic and therapeutic challenge.  We present the case of a 36-year-old man who came to our hospital's Emergency Medicine Department with an alleged history of assault with a sharp object. He sustained a stab wound over the lateral aspect of the left side of the chest associated with bleeding from the puncture site. On assessment, there was decreased air entry on the left side of the chest. A supine chest radiograph, on admission, revealed a suspicious ill-defined lucency in the subcutaneous tissues of the left chest wall. He subsequently underwent a contrast CT of the thorax on a 128-slice CT machine which revealed lung tissue in the subcutaneous plane of the left chest wall suggestive of a lung herniation. The patient underwent surgery and is recovering well. This case report highlights a unique presentation of intercostal lung hernia, emphasizing the need for early diagnosis and expeditious treatment.