Learning Radiology xray montage

Lung Hernia


General Considerations

  • Rare
  • Protrusion of lung covered by both parietal and visceral pleurae through an abnormal opening in the thoracic wall
  • Most are acquired and traumatic
    • Usually due to motor vehicle accident, prior chest tube insertion or coughing and rib fracture
  • Other causes
    • Congenital, due to developmental defects in the chest wall
      • Most frequently in the supraclavicular fossa or the anterior chest wall
      • In adults, cervical lung hernias are acquired, especially in older persons with chronic coughs and/or emphysema or in weight-lifters or those who play wind instruments
        • Care must be exercised in inserting a central venous catheter in such people
    • Secondary to infectious (e.g., TB) or neoplastic disease of the chest wall
  • Post-traumatic intercostal hernias may not appear for months or years after the trauma

Clinical Findings

  • Most are asymptomatic
  • Palpable, soft, crepitant  intercostal mass which may expand in size on inspiration or with Valsalva
  • CT is more helpful in showing the origin and size of the hernia

Imaging Findings

  • Lung tissue protruding outside of the thoracic cage
  • May be missed on radiographs unless beam is tangential to the hernia


  • Congenital cervical hernias almost always resolve spontaneously
  • Usually conservative treatment is sufficient
  • If the hernia is large or lung becomes strangulated, surgery may be required

 Lung Hernia


 Lung Hernia. There is protrusion of lung outside the thoracic cage (black arrows), This is an acquired, post-traumatic lesion caused by the previous insertion of a chest tube.

Hernia of the Lung Through the Anterior Chest Wall. M Shameema,  T Saada, R Bhargavaa, Z Ahmeda, DK Pandeya, and N


Lung Hernia: Radiographic Features. M Bhalla, BS Leitman, C Forcade, E Stern, DP Naidich and  DI McCauley. AJR. Jan 1990, Vol 154, No 1. 51-53.