Challenging Case of an Acquired Abdominal Intercostal Hernia (AAIH) after Transdiaphragmatic Intercostal Hernia (TIH) Surgery

Abstract

Background: Both acquired abdominal inter-costal hernia and trans-diaphragmatic intercostal hernias are rare clinical entities characterized by the protrusion of intra-abdominal contents or lung through a defect in an inter-costal space. Case Report: We report a rare case of inter-costal abdominal hernia in a 73-year-old patient who had already previously undergone trans-diaphragmatic inter-costal hernia surgery after a cough-induced fracture of the right costal margin associated with rib separation and subsequent abdominal visceral protrusion through inter-costal space. Conclusion: However rare, inter-costal hernias must be suspected when patients present with palpable chest swelling after trauma. CT is the elective technique to perform diagnosis and identify the presence of co-existing diaphragmatic defects or intra-abdominal lesions. Surgical repair is the treatment of choice, possibly using tension-free mesh repair. The recurrence rate is high, whichever technique is chosen.