Clinicoradiological diagnosis: Cough-induced transdiaphragmatic intercostal herniation

Transdiaphragmatic intercostal herniation can occur following blunt or penetrating trauma and is usually associated with rib fractures. It is uncommon and only sporadically reported in literature. We report a case of cough-induced intercostal herniation containing large bowel, on a background of sustaining a blunt chest trauma 25 years prior to presentation. The patient was treated by reducing the hernia followed by surgical repair of the diaphragm and intercostal muscles defect. He was discharged without further complications and remained well at follow-up.