Peer-reviewed veterinary case report
Spontaneous Transdiaphragmatic Intercostal Hernia in an Elderly Patient: A Rare Case Treated by Laparoscopic Repair.
By Boukla J et al.·2026·Abdominal Surgery and Transplantation·View original on Europe PMC →
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Plain-English summary
A 71-year-old man developed trouble breathing and some digestive issues over several months without any history of injury. Doctors found that he had a rare condition called a transdiaphragmatic intercostal hernia, where part of his intestines had moved through a hole in his diaphragm between his ribs. He had surgery using a minimally invasive technique to fix the hernia and reinforce it with mesh. After the surgery, he recovered well and showed significant improvement, with no signs of the hernia returning during an eight-month follow-up, although he did report some localized pain. Overall, the treatment was successful.
Abstract
Transdiaphragmatic intercostal hernia is a rare entity, with fewer than 50 cases reported in the literature. The majority are post-traumatic, secondary to blunt or penetrating thoracic injuries. Spontaneous forms are exceptional and often associated with risk factors such as obesity, chronic pulmonary disease, or long-term corticosteroid and immunosuppressive therapy. We present the case of a 71-year-old man with no history of trauma, who developed progressive dyspnea and subocclusive symptoms over several months. Imaging revealed a left transdiaphragmatic intercostal hernia between the seventh and eighth ribs, containing small bowel, colon, and omentum. The patient underwent laparoscopic repair with mesh reinforcement. Postoperative recovery was uneventful, with significant clinical improvement and no recurrence at eight-month follow-up. At that point, the patient reported localized neuropathic pain without radiological evidence of recurrence. This case highlights the rare occurrence of spontaneous transdiaphragmatic intercostal hernia, underlining the role of obesity and chronic immunosuppression as contributing factors, and emphasizes the diagnostic challenge of this condition as well as the feasibility and effectiveness of a laparoscopic mesh repair strategy.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41777960