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Thoracolaparoscopic management of a traumatic subacute transdiaphragmatic intercostal hernia. Second case reported
1Washington University School of Medicine in St Louis, Memorial Hospital of Carbondale - The Barnes Jewish Collaborative, United States of America.
Background:
Transdiaphragmatic intercostal hernias are extremely rare. Their physiopathology is different from traumatic diaphragmatic ruptures, and their clinical presentation and management strategies place them in a different category than abdominal intercostal hernias.
Case Presentation:
A 56 yo female presented to the outpatient trauma clinic with a symptomatic, subacute left sided transdiaphragmatic intercostal hernia secondary to a motor vehicle crash almost 3 months prior to presentation. The injury was managed with a combined thoracoscopic and laparoscopic approach, only the second time ever this has been reported. She was discharged on POD#3, and after 6 months of follow up continues to do well, without clinical evidence of hernia recurrence.
Conclusion:
Minimally invasive management of this rare pathology is possible and should be encouraged.
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