Acquired abdominal intercostal hernia: case report and systematic review of the literature

Abstract

AAIH should be always suspected when chest swelling occurs after a minor or major trauma, and CT must be promptly performed to rule out diaphragmatic or abdominal viscera injury. This condition requires surgery to prevent serious complications, the first-choice technique should be mesh tension-free repair.

Laparoscopic Repair of an Abdominal Intercostal Hernia Following Blunt Trauma: A Case Report

“…Less than 40 cases of transdiaphragmatic intercostal hernias have been reported in the literature [1,2]. Even fewer still are cases of intercostal hernias under an intact diaphragm [3]. Intercostal hernias are associated with an increase in abdominal pressure and may develop acutely or over a number of years.…”

“…Positive intrathoracic pressure forces the contents out through weakened areas of the chest wall. The majority of cases share the predisposing characteristics of obesity: COPD, advanced age, smokers, and connective tissue disorders [3]. The majority of intercostal hernias are the result of a traumatic mechanism.…”

“…The typical finding is chest swelling and a reducible bulge on the thoraco-abdominal wall. CT of the chest and abdomen is the gold standard for imaging these hernias, as chest X-ray and ultrasound lack the sensitivity to identify the contents of the hernia and whether there is obstruction or vascular compromise of herniated organs [3]. Surgery is the definitive treatment for intercostal hernias.…”

“…One approach to treatment has been to reduce the hernia and close the defect, usually with rib approximation. This open thoracoabdominal approach has been associated with recurrence, although the documented follow-up periods have been short [3]. In stable patients, the intraabdominal contents can be inspected with diagnostic laparoscopy with the possibility of a laparoscopic mesh placement if there is no contraindication to Abdominal Intercostal Hernia J Curr Surg.…”

Spontaneous Idiopathic Intercostal Hernia

“…Intercostal hernia of chest wall is more common than abdominal intercostal hernia. Recently intercostal hernias have been divided into two types: with or without diaphragmatic defect (4) . Abunnaja et al (2) reported a case of acquired abdominal intercostal hernia in a 51 years old female patient with past history of stab injury locally.…”