Journal of Surgical Technique and Case Report
Journal of Surgical Technique and Case Report
CASE REPORT
Year : 2013  |  Volume : 5  |  Issue : 2  |  Page : 106-108

Clinicoradiological diagnosis of cough-induced intercostal hernia


Department of Surgery, Winter Park Memorial Hospital, Winter Park, Florida, USA

Correspondence Address:
Andrew Dobradin
320 North Edinburgh Drive, Suite B, Winter Park, Florida 32792
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2006-8808.128754

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Cough-induced intercostal hernias without any type of external trauma are very uncommon. There have been less than 10 cases documented in literature. This clinical report describes a 66-year-old male who developed an intercostal hernia induced by a severe cough due to bilateral pneumonia and a subsequent rib fracture. It took almost a full year to diagnose this patient's chest wall mass. Only after taking careful history and reviewing all the images, the diagnosis of intercostal hernia was made. He was referred to a cardiothoracic surgeon for treatment. Intercostal hernias can be caused by the sheer exertion of coughing without any prior history of trauma to the chest wall or abdomen. Early diagnosis is difficult and had to be based on clinical signs and symptoms. The imaging studies might help to establish diagnosis, but cannot replace a diligent examination and clinical interview. The treatment of the chest wall defect is case dependent. Surgical repair reinforcement of the intercostal muscles might be required with prosthetic nonabsorbable (polypropylene) mesh.


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