The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 856-857, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Intercostal pleuroperitoneal hernia
EJ Croce and VA Mehta
The patient described in this report had the initial symptoms and signs of
a fractured right ninth rib followed soon by severe signs of trauma to the
local chest wall. In the ensuing 5 months sequella suggesting an
intercostal hernia gradually developed. Further studies indicated that this
hernia consisted of a posterior pleural and anterior peritoneal component.
At operation the diaphragm was found to have torn away from its costal
attachments. In addition to repairing the intercostal pleural hernia, we
recommend that a strip of Marlex mesh be fixed to the inner costal surfaces
to form a continuous and durable new attachment for the diaphragmatic
margin prior to the repair of the peritoneal component. Determining a
probable explanation for the mechanism of the injury was helpful in
understanding the reconstruction procedure.