Intercostal hernia secondary to penetrating trauma presenting as an abdominal swelling: A rare case

Abstract

Abstract Intercostal hernia (ICH) is a type of hernia, in which the sac or contents (lung, liver, bowel, or stomach) protrude through the intercostal space. It can be categorized either into acquired or congenital types, with or without a diaphragmatic defect. We report the case of a 45-year-old man who presented to a surgical clinic with irreducible swelling in his right upper abdomen for 7 months. Patient had a history of stab injury at the same site 7 years ago. Intraoperatively, a sac containing omentum was found arising through a defect of 2 cm × 2 cm burrowing below, in the 9th intercostal space, to manifest as a subcostal bulge with complete disruption of the sternocostal joint of the 9th rib. The procedure done was an onlay mesh hernioplasty. ICH, though a rare entity, should be kept in mind as a differential diagnosis in patients with a history of thoraco-abdominal trauma. It may require modifications in the operative technique or even thoracic exploration in extreme cases.