A 40-year-old woman in Birmingham, West Midlands, U.K., is the subject of a disturbing new report in the New England Journal of Medicine. MSNBC reports that during a violent coughing fit, the woman came as close as possible to coughing up a lung. The official diagnosis was herniated lung.
Chest pains, coughs, cracks and pops
After two days of acute onset pleuritic chest pain on her right side, the British woman went to Good Hope Hospital in Birmingham for relief. An asthma sufferer, the woman had been coughing hard for two weeks and had been taking antibiotics for a lower respiratory tract infection.
Doctors who examined her at the hospital noticed cracking and popping sounds coming from her right mid-axillary line, on the right side of her torso. X-rays revealed that the woman had coughed so hard that she’d herniated her lung, causing part of it to pop through her ribs. Her medical history includes no signs of trauma, although NEJM does note that she has experienced hypertension, depression and osteoporosis.
Using proper violent cough nomenclature
Dr. Rachel Vreeman, co-author of the book “Don’t Cross Your Eyes … They’ll Get Stuck That Way!”, told MSNBC that people shouldn’t jump to obvious conclusions over this medical oddity.
“While she didn’t technically cough up her lung, she coughed out her lung, through her ribs,” said Vreeman. “It’s so unusual to have this happen that it would merit this case report — unusual, but possible, apparently.”
The woman’s lung tissue slipped between two of her ribs, specifically the ninth intercostal space. This is not unlike another case recently documented by the NEJM in which a woman’s breast implant popped through her ribs while she was doing Pilates. It went into the pleural cavity, which is the space between the lungs.
Vreeman notes that the patient likely has some form of defect that makes the area between her ribs particularly vulnerable.
“It really must have been some intense coughing,” said the doctor. “There are reports — it’s incredibly rare — of people who have had their spleens ruptured because of coughing. There also are occasional reports of people who are more prone to having their eyeballs coming out of their sockets.”
“Don’t Cross Your Eyes… They’ll Get Stuck That Way!”: http://amzn.to/wmDFAK
New England Journal of Medicine: www.nejm.org/doi/full/10.1056/NEJMicm1106070
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