Abstract
BackgroundCoughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four.Case presentationIn this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months.ConclusionThis case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition.
Highlights
Coughing is considered an important mechanism that helps rid the body of foreign substances or prevent their entry into the tracheobronchial tree [1]
After the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures [3]
Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four [3]
Summary
Coughing is considered an important mechanism that helps rid the body of foreign substances or prevent their entry into the tracheobronchial tree [1]. The uniqueness of this report is its description of the oddly large number of rib fractures involved in a healthy smoker with no relevant history of diseases. This case report may prompt attention to the importance of addressing the issue of cough-induced rib fracture and of dealing with chronic cough to avoid such complications. Rib fractures occur normally with chronic cough following either respiratory system infections, chronic obstructive pulmonary disease, or bronchial asthma under steroid therapy These were concluded to be risk factors for cough-induced rib fracture [6]. Fracture locations in our patient were the anterior arch of the ninth left rib and the anterior arches of the fifth, sixth, and seventh right ribs, creating aligned foci and double fractures in the anterior bow of the fifth right rib, in compliance with previously reported data
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