M Abu-Gazala1, A Ratnayake, S Abu-Gazala, M Bala. 1. Department of General Surgery, Hadassah-Hebrew University Medical Center, PO Box 12000, 91120 Jerusalem, Israel.
Abstract
INTRODUCTION: Cough can be associated with many complications. MATERIALS AND METHODS: We present a 59-year-old male patient with a very rare combination of a cough-related stress fracture of the ninth rib and herniation through the diaphragm and abdominal wall to the subcutaneous tissue of the chest wall. We suggest thoracotomy through the affected intercostal defect as a surgical approach. The diaphragm, chest wall and abdominal tears were repaired separately, and the abdominal wall was reinforced with mesh. Technical aspects were discussed. CONCLUSIONS: Though each individual injury is well documented in the literature, this is a rare combination of defects, requiring early recognition to provide repair before incarceration and further enlargement of the defects occur.
INTRODUCTION: Cough can be associated with many complications. MATERIALS AND METHODS: We present a 59-year-old male patient with a very rare combination of a cough-related stress fracture of the ninth rib and herniation through the diaphragm and abdominal wall to the subcutaneous tissue of the chest wall. We suggest thoracotomy through the affected intercostal defect as a surgical approach. The diaphragm, chest wall and abdominal tears were repaired separately, and the abdominal wall was reinforced with mesh. Technical aspects were discussed. CONCLUSIONS: Though each individual injury is well documented in the literature, this is a rare combination of defects, requiring early recognition to provide repair before incarceration and further enlargement of the defects occur.