CASE REPORT: SURGICAL MANAGEMENT OF TRAUMATIC PULMONARY HERNIA.

Introduction: The traumatic pulmonary hernia is a rare and uncommon encounter in trauma care. Most traumatic lung hernias have been reported secondary to falls, motor vehicle accidents, and penetrating chest trauma. Early surgical repair offers the best results with a low morbidity, and the long-term prognosis is excellent. Case Report: Our paper aims to discuss the surgical management of a 52-year-old male patient who presented at the emergency room with acute respiratory insufficiency. Upon examination, he was diagnosed with a right thoracic penetrating wound associated with a suffocating pneumothorax, subcutaneous emphysema, and two rib fractures adjacent to the penetrating wound. The injuries were sustained during a biking accident, where the handlebar penetrated the right hemithorax.The contrast-enhanced thoracic CT scan revealed on the right hemithorax fine fracture line of the 5th rib (inferior edge), an open fracture of the 6th rib (the lateral arch), a 1 cm herniation area of the pulmonary parenchyma in the 5-6th intercostal space, a small pneumothorax (6 mm) and subcutaneous emphysema. The surgical treatment involved two hemostatic subcutaneous sutures with reintroduction of the lung in the pleural cavity and placement of a right passive pleural drain. Discussions : The patient's postoperative early status faced no complications; control thoracic x-rays were performed with fluid secretions monitorization. On day three, the drainage was clamped with a 24-hour monitoring of saturations and a thoracic X-ray at the end. The pleural drainage was removed on day four, together with the discharge. Postoperative controls revealed no modifications to the patient's respiratory function. Conclusions: This case underscores the importance of considering uncommon etiologies in patients presenting with thoracic symptoms and the critical role of prompt surgical correction to prevent potential complications such as respiratory compromise or organ dysfunction. The best imaging technique for such cases is trauma control computed tomography, which better defines the hernia dimensions and associated thoracic and pleural damage. [ABSTRACT FROM AUTHOR]