Acute intercostal pulmonary hernia on postoperative day 5 following uniportal video-assisted thoracoscopic surgery: Successful emergency manual reinsertion case report and literature review.

RATIONALE: An intercostal pulmonary hernia is an uncommon condition characterized by protrusion of the pulmonary parenchyma into the thoracic cavity through a compromised or defective chest wall. However, pulmonary hernia management remains debated.

PATIENTS CONCERNS: In this case report, we present a patient who developed an acute pulmonary hernia on the 5th day after uniportal video-assisted thoracoscopic pulmonary surgery. A 57-year-old male patient developed an acute cough accompanied by high fever and reported pain at the left incision site.

DIAGNOSES: A chest computed tomography scan revealed that the diameter of the hernia sac neck was approximately 4.88 cm, while the maximum diameter of the pulmonary hernia was approximately 6.59 cm.

INTERVENTIONS: The pulmonary hernia was successfully treated by manual reinsertion.

OUTCOMES: Follow-up examinations with chest computed tomography and radiography were conducted on the day of manual reinsertion, 3 days later, and 2 weeks after discharge; these assessments indicated that there was no recurrence of pulmonary hernia.

LESSONS: This report represents the 1st documented instance of manual reinsertion for acute pulmonary hernia and demonstrates that this therapeutic approach is both safe and feasible. However, a larger sample size and a longer follow-up period are required.