CTICasesTranscostal Lung Herniation post-Clamshell Incision
Imaging findings
CT chest shows symmetric protrusion of lung tissue through the intercostal spaces of the anterior chest wall, occurring at the lateral margins of a previous bilateral thoracotomy (clamshell) incision.
Key takeaways
Lung herniation is an iatrogenic complication following thoracotomy. Clamshell incisions involve division of the sternum and intercostal muscles; poor tissue approximation or wound dehiscence at the lateral margins can allow lung tissue to herniate through the chest wall, typically presenting as a soft, reducible mass.
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