Lung herniation through the thoracic wall after persistent sneezing and coughing in an obesity and COPD Patient

We present the case of a 61-year-old male patient with a known medical history of morbid obesity, chronic obstructive pulmonary disease and atrial fibrillation, who was receiving anticoagulation therapy with enoxaparin natrium prescribed by his family physician. The patient presented himself to the emergency department of our hospital with a complaint of severe pain in the right hemithorax, dyspnea, and diffuse cutaneous and subcutaneous haematoma in the inferior part of the right hemithoracic region. The patient underwent right-side video-assisted thoracic surgery on the second day to evacuate the haematothorax. Thoracic wall repair was achieved using a sandwich technique with a sublay reinforced with pericostal sutures and onlay insertion of bovine pericardium mesh.