THORACIC-ABDOMINAL HERNIA - CASE PRESENTATION
Abstract:
Thoracic hernia, described as the protrusion of the lung through the chest wall, is one of the
rarest pathologies and can be post-traumatic, post-thoracotomies, spontaneous or congenital. After
chest trauma, the thoracic hernia can occur immediately, and in some other cases, spontaneous or
congenital intercostal hernias can be both symptomatic and asymptomatic. The most common
complications are incarceration, followed by strangulation, which can lead even to death in the
absence of surgical treatment. Case presentation: we aim to present a 70-year patient with no history
of chest trauma or chest surgery admitted to our clinic complaining of a painless, protrusive,
expansive tumour of approximately 4x10 cm on VII-IX intercostal space. After clinical examination
and imaging investigations, the diagnosis of thoracic hernia was sustained. After appropriate
preoperative preparation, the surgical intervention was performed, which consisted of preparation of
the diaphragmatic hernia sac, discovered intra-operatively, followed by folding diaphragm suture,
peri-costal fixation of the adjacent ribs, and a restoration of the abdominal wall with a Pro-Grip
synthetic mesh, (associated abdominal hernia), followed by pleural and subcutaneous drainages. The
patient’s evolution was a good one, and on the 8th postoperative day was discharged in good
condition. Conclusions: although some thoracic hernias benefit from conservative treatment and
sometimes clinical surveillance is accepted, surgical treatment is the gold standard for intercostal
pulmonary hernias, which prevents complications. Over time, many surgical techniques have been
discussed and implemented, but the most important thing nowadays is the management
full text article in English (.EN) |