Posttraumatic transdiaphragmatic intercostal hernia: report of a case and review of the literature

Int Surg. 2015 Mar;100(3):444-9. doi: 10.9738/INTSURG-D-13-00272.1.

Abstract

Intercostal hernias are rare, and usually occur following injuries of the thoracic wall. The scope of this report is to present a case of a 53-year-old obese patient that developed a transdiaphragmatic intercostal hernia. The patient presented with a palpable, sizeable, reducible mass in the right lateral thoracic wall, with evident bowel sounds in the area, 6 months after a motor-vehicle accident. On computed tomography (CT), the hernia sac contained part of the liver and part of the ascending colon. A surgical repair of the defect was performed, using a prosthetic patch. The patient's postoperative course was uneventful and she remains recurrence free at 12 months after surgery. Intercostal hernias should be suspected following high-impact injuries of the thoracic wall, and CT scans will facilitate the diagnosis of intercostal hernia. We consider the surgical repair of the defect, with placement of a prosthetic mesh, as the treatment of choice to ensure a favorable outcome.

Keywords: Abdominal; Hernia; Intercostal; Mesh; Transdiaphragmatic.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Female
  • Hernia, Diaphragmatic, Traumatic / diagnosis*
  • Hernia, Diaphragmatic, Traumatic / etiology
  • Hernia, Diaphragmatic, Traumatic / surgery
  • Herniorrhaphy / instrumentation
  • Herniorrhaphy / methods*
  • Humans
  • Middle Aged
  • Surgical Mesh
  • Thoracic Injuries / complications*
  • Thoracic Wall / injuries*