A 20-year-old healthy male presented to the emergency department after falling from a skateboard. He sustained blunt trauma to his right chest wall, resulting in pleuritic pain and mild dyspnea. Diagnostic workup included chest radiography (CXR), which showed no acute findings (). Further evaluation with chest computed tomography (CT) scan demonstrated fractures of the right 4th through 6th ribs. Herniation of the middle lobe of the right lung was also identified on CT scan ().\nThe patient was admitted for observation and pain management. His pain and dyspnea improved and he was managed conservatively. A repeat CXR on hospital day two was stable, and the patient was discharged home. Ten days after discharge a follow-up chest CT scan was completed and demonstrated a decrease in herniated lung ().
A 23-year-old healthy Greek male, came to the outpatient clinic of our hospital for a routine examination for employment. During the examination, he mentioned that his right chest wall protruded whenever he performed a Valsalva's maneuver (). He said that it happened since he was a child and he had been informed that it was a benign condition. The rest of the clinical examination, pulse oximetry as well as spirometry were normal. His chest radiography revealed that the 8th and 9th ribs on the right departed from each other leaving a gap (). This configuration could explain the transient lung herniation that happened whenever the intrathoracic pressure was increased (e.g. during cough, Valsalva's maneuver etc).\nAs the patient was asymptomatic, no further intervention was considered.