Transdiaphragmatic Intercostal Hernia Repair in a Patient with Previous Thoracic Surgery

Abstract

A transdiaphragmatic intercostal hernia (TDIH) describes the herniation of abdominal contents through diaphragm and chest wall defects. It has been documented following traumatic injuries as well as after episodes of increased thoracoabdominal pressure. However, those resulting from iatrogenic cause remain uncommon and are less often recorded. We report an iatrogenic TDIH in a patient presenting 39 days after a complicated thoracic procedure, highlighting the surgical technique used for successful hernia reduction, diaphragmatic closure, and rib re-approximation. The case reinforces the possibility of a TDIH occurring as a post-surgical complication. Surgeons should anticipate the potential development of TDIH, particularly after thoracic procedures in patients with significant pre-existing conditions, such as chronic obstructive pulmonary disease (COPD) and cirrhosis. Such clinical awareness should be coupled with apt corrective surgical strategies thereby providing greater opportunity for successful patient recovery.