Cough leads to lung herniation through chest wall (Image, NEJM)

A 40-year old asthmatic woman coughed the corner of her right lower lobe right through her chest wall, needing a thoracotomy to repair it. She seemed to have recovered well at 3-month follow-up. Matthew O'Shea and Morgan Cleasby of Good Hope Hospital in Birmingham (United Kingdom) share their fascinating pictures in a New England Journal show-and-tell.

O'Shea M, Cleasby M. Lung Herniation after Cough-Induced Rupture of Intercostal Muscle. N Engl J Med 2012;366:74.