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Fell and broke rib. Bruised lung. No pain. Have coughing and phlegm. Pain during cough. Normal?

Answered by
Dr.
Dr. Shashi Dangwal

Pulmonologist

Practicing since :1979

Answered : 1126 Questions

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Posted on Mon, 26 Aug 2013 in Lung and Chest disorders
Question: Passed out in bathroom while p-ing, and fell. Aparently hit corner of something on the way down, and broke a rib. Think I also bruised lung. Rt side, middle of cage.
NO initial pain, but almost put me on floor a few mins later when I coughed. (Smoker). Soon had excess phlegm, clear but bubbly, continuing for days. Avoiding coughing, it got to gurgling when I had to cough it out. EXTREMELY painful. I can hear and feel the rib pop back in place after cough. Phlegm reduced, but still more than normal.
Motrin 800 helps.
Is it going to heal itself? Concerned about the popping back into place. Now 2 1/2 weeks. No Dr.
doctor
Answered by Dr. Shashi Dangwal 40 minutes later
Hello XXXXX,

The pain is because of the injury to the rib which may be a contusion or a fracture. From your description it looks more like a fracture.

You may have injured the lung especially with the sharp edge of the broken rib if there has been a fracture. Even if you have injured the lung, it does not appear to be serious as it`s already more than 2 1/2 weeks and you have not developed any major problem, rather your symptoms seem to be subsiding.

If you really want to confirm the diagnosis, you may go in for a x XXXXXXX chest or a CT chest. CT chest will show any damage to the lung better than a x XXXXXXX

Yes it will heal by itself gradually over a period of time. Popping back in place is a good sign and it means that the broken ends of the rib are aligned and will heal faster. Pl avoid strenuous exercises.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shashi Dangwal 24 hours later
Thanks. I should have phrased the question better.

The rib pops out with almost every cough, which are far greater than just a few, and usually pop back in within a minute or few. Sometimes with just an exhale.

Knowing how a bone normally heals, I'm concerned that this rib is not in place long enough between coughs to be able to begin healing.

The pain now is mostly related to the coughing, with some when lifting rt arm. Minimal pain with deep breathing. The coughing is about 50/50 from phlegm and smoking. The smoking cough is not nearly as hard as the phlegm removal.

I'm unaware of any procedure to fix a rib in place, and wraping isn't recommended due to shallow breathing.

I sleep on rt side, which helps, and try to only cough at nite when the gurgling starts.

So, ideas; recommendations; thoughts? Is this gonna heal? Is the rib popping the reason for the continued phlegm production? No alergies, and nothing else has changed recently.
doctor
Answered by Dr. Shashi Dangwal 10 minutes later
Hi,

Yes you are right- it may be a complete thru n thru fracture and both ends may be moving when you are coughing.

The fracture will still heal over a period of time. Take some cough remedies- foremost being smoking cessation.

Strapping is an answer, may be for a short period.

You may consult an orthopedic surgeon for better options for rib fracture.

Bye.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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