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Case reports

Cough-induced rib fracture and diaphragmatic rupture resulting in simultaneous abdominal visceral herniation into the left hemithorax and subcutaneously

University Hospital, Coventry, UK

Received 29 April 2008; accepted 16 June 2008.

^_* Corresponding author. Address: Department of Cardio-thoracic Surgery, University Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK. Tel.: +44 2476535906; fax: +44 1216037085. (Email: joe.marzouk{at}uhcw.nhs.uk).

Violent coughing is associated with a multitude of complications including rib fractures and diaphragmatic rupture. In this report we present a case of a 70-year-old male with the rare combination of both complications resulting in herniation of bowel into the left hemithorax and subcutaneously between the separated ribs. Surgical repair was performed via a left thoracotomy, the hernia reduced and the diaphragmatic and chest wall defect repaired primarily with excellent patient recovery and relief of symptoms.

Key Words: Diaphragmatic hernia • Rib fracture