Rev Mal Respir

. 2022 Jun;39(6):561-565.

 doi: 10.1016/j.rmr.2022.04.003. Epub 2022 May 13. https://pubmed.ncbi.nlm.nih.gov/35570035/

[Diaphragmatic rupture and right ipsilateral intercostal hernia in chronic cough]

[Article in French]

E Cloche ¹, G Dessertenne ¹, J-C Callahan ¹, F Pinquie ¹, J Barbieux ²

Affiliations expand

• PMID: 35570035
• DOI: 10.1016/j.rmr.2022.04.003

Abstract

Introduction: We are reporting the case of a 64-year-old patient with chronic cough who has been diagnosed with an intercostal hernia with pleural and hepatic content associated with a diaphragmatic hernia of non-traumatic origin.

Case report: The patient was treated for an acutely febrile cough with signs of respiratory distress. Thoracic scan showed an intercostal hernia containing an encysted hematoma and a right anterior diaphragmatic hernia with epiploic content. The COVID PCR was negative. This is one of the rare reported cases of intercostal hernia associated with a homolateral diaphragmatic rupture. Visceral and thoracic surgery enabled treatment of the two hernial orifices by raphy as well as omentectomy of the necrotic omentum ascending to the right pulmonary hilum.

Conclusion: These two parietal complications of chronic cough should be considered in case of intercostal flap or acute respiratory distress. Surgery must then be carried out as a matter of urgency to reduce the content of the hernias and treat the musculoaponeurotic dehiscent orifices.

Keywords: Acute respiratory distress syndrome; Cough; Hernie diaphragmatique traumatique; Respiratoire aiguë; Syndrome de détresse; Toux; Traumatic diaphragmatic hernias.

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