TRAUMATIC PULMONARY HERNIA - SURGICAL VERSUS CONSERVATIVE MANAGEMENT

The therapeutic management of lung herniation, an uncommon complicatio n of severe blunt chest trauma, remains controversial, We report here on two cases of traumatic lung herniation with different, yet successf ul, methods of therapeutic management according to the particular anat omic types, Because of the threat of tension pneumothorax, incarcerati on, or strangulation of the lung parenchyma in mechanically ventilated patients, surgical reduction of intercostal pulmonary hernias with na rrow necks is usually recommended, In contrast, supraclavicular pulmon ary hernias secondary to clavicle-sternal dislocation may be treated c onservatively with serial clinical and thoracic imaging follow-up incl uding chest computed tomographic scan, In this anatomical type of lung herniation, favorable spontaneous evolution is frequently observed, p resumably because of the presence of a larger thoracic wall defect tog ether with the absence of associated perforating bone trauma, The effi cacy of the therapeutic approach proposed herein remains to be confirm ed by further experience.