CTICasesIntercostal Lung Herniation through Bilateral Thoracotomy Defects
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Imaging findings
Chest CT shows bilateral surgical defects (thoracotomies) in the chest wall. Dynamic imaging or coronal reformats during inspiration and expiration demonstrate soft tissue (lung and pleural fat) herniating back and forth through the thoracotomy defects.
Key takeaways
Lung herniation can occur through thoracotomy defects due to structural weakness of the intercostal muscles following surgery. The herniation of lung tissue is highly dynamic and can be beautifully demonstrated on inspiration and expiration CT scans, which help explain transient, fluctuating extrapulmonary opacities seen on chest radiographs.
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