Spontaneous transdiaphragmatic intercostal hernia: a rare clinical entity

Area of Science:

• Thoracic surgery
• Abdominal surgery
• Diaphragmatic pathology

Background:

• Transdiaphragmatic intercostal hernia (TDIH), also known as intercostal pleuroperitoneal hernia, involves abdominal contents herniating through a diaphragmatic and chest wall defect.
• This acquired condition typically results from trauma disrupting diaphragmatic or intercostal muscles.

Observation:

• An elderly male presented with a reducible left chest lump and exertional dyspnea.
• Notably, the patient had no history of trivial or occult trauma preceding the symptoms.

Findings:

• The case highlights an unusual presentation of TDIH without a clear traumatic etiology.
• Surgical management alone proved adequate for resolving the herniation and associated symptoms.

Implications:

• This case expands the understanding of TDIH etiology, suggesting non-traumatic causes are possible.
• It underscores the importance of surgical intervention for symptomatic TDIH, even in the absence of trauma.