Posterior trans-mediastinal lung herniation in a postoperative Marfan's patient

Thoracic hernias are defined as the protrusion of contents either into or outside of the thoracic cavity. These hernias can be acquired or congenital and occur in varying locations. Acquired thoracic hernias typically develop after surgery or trauma. The most common form is intercostal herniation due to thoracotomy. Trans-mediastinal herniation of the lung is even less common, typically seen in patients with sequestration, scimitar syndrome, or pneumonectomy, and, when present, commonly occurs across the anterior mediastinum. Here, we present to our knowledge the first known case of posterior trans-mediastinal lung herniation diagnosed on CT after thoracoabdominal aneurysm repair in a patient with Marfan's disease, highlighting the importance of evaluating for rare anatomic complications in the post-operative setting. (1) •Thoracic hernias are defined as the protrusion of contents either into or outside of the thoracic cavity.•These hernias can be acquired or congenital and occur in varying locations.•Acquired thoracic hernias typically develop after surgery or trauma.•The most common form is intercostal herniation due to thoracotomy.•Trans-mediastinal herniation of the lung is even less common, typically seen in patients with sequestration, scimitar syndrome, or pneumonectomy, and, when present, commonly occurs across the anterior mediastinum.