Lung Hernia

What is a Lung Hernia?

When someone says “hernia,” most people think of the area below the abdomen, where part of the intestine has pushed through a tear in the muscle wall caused by a strain, such as lifting a heavy object. A lung hernia refers to part of a lung pushing through a tear, or bulging through a weak spot, in the chest wall, neck passageway or diaphragm.

This condition as a natural, congenital occurrence is rare—less than one in five cases reported. Most people who experience a lung hernia suffered a severe trauma such as a traffic accident in which the chest is injured. Lung hernias by themselves aren’t life threatening. They might not even be all that troublesome. They’re fairly easy to locate, diagnose, and correct.

The Mechanics of Lung Hernias

As a person inhales, the lungs expand. This in turn expands the chest. If there is an opening or a soft spot in the chest wall, neck opening or diaphragm, it’s possible that the lung as it expands will push through or cause a bulge at that point. Two out of three lung hernias involve the chest (thoracic) wall, and most of the rest involve the neck (cervical) area. Lung hernias related to the diaphragm are uncommon and limited mainly to congenital conditions in infants.

In a number of cases, lung hernias occur and persist without bothersome effects. In others, the person might feel sore or have trouble breathing. Some infants with herniated diaphragms at birth can have organs located up in the chest cavity. This can cause so much pressure on the lungs that they don’t develop properly.

Symptoms of Lung Hernias

When symptoms of a lung hernia do arise, they tend to be fairly clear cut. They include:

• Sharp pain when inhaling, coughing, or sneezing
• Difficulty breathing deeply or a shortness of breath
• General soreness in a particular area of the chest
• Swelling in a particular area of the chest
• Fever

It’s possible that these symptoms will become more severe over time, but it’s not always the case.

Causes of Lung Hernias

Most lung hernias are the result of injury or trauma to the chest area, such as a fall or car accident. But there are a number of other possible causes. They include:

• Illness or surgery in which the chest wall is weakened or altered
• A coughing “jag” or even a single harsh cough
• Chest wall muscle strain resulting from lifting
• Congenital deformity
• Chronic use of steroids

Diagnosing Lung Hernias

Lung hernias are fairly easy to locate and diagnose. The affected area is usually plainly observed in a chest x-ray. In cases where the capabilities of an x-ray are insufficient, a CT (computed tomography) scan is able to see the affected area in great detail. Doctors will look for a gap in the thoracic wall or cervical membrane, or for a protrusion or bulging shape in the lung.

Treating Lung Hernias

In mild to moderate cases, a conservative regimen might be sufficient to provide relief. The patient is likely to respond to bed rest, analgesic pain medications, cough suppressants, infection fighters, and other basic treatment.

In the case of a more severe or a larger lung hernia, surgery will be the answer. While certainly an invasive procedure, operations to correct the conditions leading to lung hernias are thoroughly understood and highly successful. A doctor basically returns the lung to its proper position and then stitches up the opening or reinforces the weakened area of the chest. Surgery, generally, is not the preferred treatment for lung hernias in the cervical region, no matter how severe. But surgery is routinely performed for lung hernias involving the thoracic wall and diaphragm.

Cough With Care
Of all the possible reasons for a person to develop a lung hernia, coughing is hard to take seriously. But it turns out that you can indeed tear a chest muscle or open an old incision with a sharp cough—and that can lead to a lung hernia. A cough may be harder to control than what amount of weight to lift (another way to tear a muscle). But it’s still smart to cough with care.