Surgical vs. nonsurgical management of post-traumatic intercostal lung herniation in children

Postraumatic intercostal lung herniation in children is a rare condition. Including our case reported here, there are only 16 reported cases. In children ILH is mostly seen after blunt chest trauma caused by bicycle handle bar injury. Given the rarity of the condition, the pediatric literature on this subject is scarce, with no published guidelines or evidence based recommendations for imaging and management approaches (surgical vs. nonsurgical). Although rare, the pediatric surgeon should be familiar with this condition in order to avoid potentially harmful, invasive or unnecessary diagnostic and therapeutic approaches that are extrapolated from experience in adult patients. Noninvasive imaging modalities including chest radiographs and ultrasound, and nonsurgical management of posttraumatic intercostal lung herniation should be considered as an initial treatment option in the management of asymptomatic patients.