TY - JOUR T1 - Lung herniation following a severe traumatic chest wall injury JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2021-000880 VL - 7 IS - 1 SP - e000880 AU - Suraj Panjwani AU - Daniel Walker AU - Jonathan Gates AU - Mario Katigbak AU - Daniel Ricaurte Y1 - 2022/03/01 UR - http://tsaco.bmj.com/content/7/1/e000880.abstract N2 - A male patient in his 70s presented after a farming tractor ran over his chest. On arrival to the trauma bay he was hemodynamically stable, with significant chest pain and paradoxical movement of his chest with respirations. Cross-sectional imaging revealed a sternal fracture, moderate posterior displacement of the sternomanubrial joint, left-sided second through fourth rib fractures with moderately sized hemothorax and a right sixth rib fracture (figure 1). A left-sided chest tube was placed. The patient was taken to the operating room on hospital day 2 for reduction of the sternomanubrial dislocation and open reduction with internal fixation (ORIF) of the sternum by plastic surgery. He was successfully extubated on postoperative day 1. On postoperative day 5, the patient was noted to have a prominent bulge on his right anterior chest, most pronounced during inspiration. CT of the chest revealed herniation of portions of the right upper and middle lobe through the right anterior chest … ER -