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This revealed new intercostal lung herniation that was not present on CT pulmonary angiography performed 4\u2009days earlier. Clinical deterioration necessitated surgical intervention, including haematoma evacuation, reduction of herniated lung and costal arch repair. Flexible bronchoscopy was performed for secretion clearance and microbiological sampling. This case highlights the importance of considering spontaneous lung herniation following forceful coughing in patients with recognised risk factors.<\/jats:p>","DOI":"10.1136\/bcr-2026-272696","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:45Z","timestamp":1785158445000},"page":"e272696","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cough-induced chest wall trauma with spontaneous intercostal lung herniation complicated by haemothorax"],"prefix":"10.1136","volume":"19","author":[{"given":"Nikolai","family":"Khutoryanskiy","sequence":"first","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payam","family":"Soleimani-Nouri","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Nottingham City Hospital, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Addae-Boateng","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Nottingham City Hospital, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026090306051963000_19.7.e272696.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04077-8"},{"key":"2026090306051963000_19.7.e272696.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-192508000-00006"},{"key":"2026090306051963000_19.7.e272696.3","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2022.1091727","article-title":"Case Report: Spontaneous lung intercostal hernia series and literature review","volume":"9","author":"Ugolini","year":"2022","journal-title":"Front Surg"},{"key":"2026090306051963000_19.7.e272696.4","first-page":"75","article-title":"Hernies du poumon","volume":"1","author":"Morel-Lavall\u00e9e","year":"1847","journal-title":"Bull Mem Soc Chir Paris"},{"key":"2026090306051963000_19.7.e272696.5","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/crj.12609","article-title":"Clinical importance of cross-sectional area of intercostal muscles in patients with chronic obstructive pulmonary disease","volume":"12","author":"Ju","year":"2018","journal-title":"Clin Respir J"},{"key":"2026090306051963000_19.7.e272696.6","doi-asserted-by":"publisher","DOI":"10.4103\/lungindia.lungindia_540_20"},{"key":"2026090306051963000_19.7.e272696.7","doi-asserted-by":"crossref","unstructured":"Leivaditis V , Grapatsas K , Papatriantafyllou A , et al . 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