Traumatic Diaphragmatic Hernia Presenting as an Intercostal Hernia

Intercostal hernias are rarely reported in the literature. We report a case of intercostal hernia secondary to a ruptured right hemidiaphragm and fractured costal margin caused by blunt trauma. The patient was ventilated at initial hospitalization because of rib fractures and advanced age, and the intercostal hernia was not evident. After physical rehabilitation treatment elsewhere, a painful chest wall bulge developed. A chest film and computed tomographic scan revealed the hernia. Surgery with a thoraco-abdominal incision in the line of the hernia allowed reduction of the hernial contents.