Combined Acquired Abdominal and Transdiaphragmatic Intercostal Hernia: A Case Report

Background: Intercostal hernias are rare types of hernias occurring mainly due to trauma to the chest wall. There are two main types, acquired abdominal intercostal hernia and transdiaphragmatic intercostal hernia. The occurrence of each one alone is uncommon, however the parallel presentation of both types in the same patient is highly unusual. Case Report: A 40 years old male presented with a one year history of a bulge over the left chest wall almost 7 years after penetrating and blunt trauma to the left chest wall. He was found to have both an acquired abdominal intercostal hernia and a transdiaphragmatic intercostal hernia. Both defects were repaired successfully through a laparotomy with reduction of hernia contents and repair using a prosthetic mesh. Conclusion: The diagnosis of intercostal hernias should be considered in patients presenting with a swelling on the chest wall particularly after any form of trauma to the area. Imaging may guide diagnosis however it is mostly clinical. Most cases need surgical repair.