CTICasesLung Hernia through a Prior Thoracotomy Site
Imaging findings
Chest radiograph shows volume loss on the side of prior lung surgery with an elevated hemidiaphragm and a curious focal lucency that, on the lateral view, corresponds to lung tissue jutting anteriorly through the chest wall; CT in this patient with severe emphysema confirms lung herniating through a defect at the site of prior thoracotomy.
Key takeaways
This represents a chronic lung hernia at a prior thoracotomy site, a recognized phenomenon in patients with chest wall weakness after thoracic surgery, producing a fluctuating, dynamic chest wall lump with breathing; similar hernias have previously been reported to give rise to reticulation or cavity-like lesions near the rib deformity from ongoing mechanical rubbing rather than infection, and this pattern is seen with some frequency in lung transplant recipients who undergo thoracotomy rather than a minimally invasive approach.
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