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Case Reports
. 2016 Nov 2;2(4):20150469.
doi: 10.1259/bjrcr.20150469. eCollection 2016.

An unusual case of intercostal muscle flap ossification mimicking an intrathoracic rib

Sharif Abdullah  1 , Ming Hao Guo  2 , Gail Darling  3 , Demetris Patsios  1
Affiliations
Case Reports

An unusual case of intercostal muscle flap ossification mimicking an intrathoracic rib

Sharif Abdullah et al. BJR Case Rep. .

Abstract

We present a unique case of intercostal muscle flap (ICMF) ossification mimicking an intrathoracic rib diagnosed 3 years after oesophageal perforation repair. A 58-year-old male presented with complaints of mild chest discomfort. Three years ago he had undergone left thoracotomy and primary repair of post-emetic oesophageal perforation. An ICMF had been used to strengthen the repair. Chest X-ray identified a linear calcific density within the left hemithorax. Subsequent thoracic CT characterized the anomaly as ossification of the ICMF. The lesion had the appearance of a well-differentiated intrathoracic rib coursing through the left lower lobe. We discuss the typical appearances of ossified ICMFs and the potential complications resulting from this ossification.

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Figures

Figure 1.
Figure 1.
(a) Chest radiograph showing a linear calcific density in the left hemithorax representing the ossified component of the ICMF. (b) Comparison chest radiograph performed 2 years earlier demonstrating absence of the calcific density.
Figure 2.
Figure 2.
Left anterior oblique reformatted CT image demonstrating the ICMF arising from the left sixth intercostal space. Central ossification resembling a rib is shown.
Figure 3.
Figure 3.
Axial CT image demonstrating a patent oesophagus containing oral contrast (black arrow) at the level of the anastomosis between the distal oesophagus and the ICMF. A surgical staple is shown at the site of anastomosis (white arrow).
Figure 4.
Figure 4.
Three-dimensional volume rendered CT images demonstrating the ossified component of the intercostal muscle flap.
Figure 5.
Figure 5.
Axial CT image demonstrating the position of the ossified intercostal muscle flap within the left lower lobe.
See this image and copyright information in PMC

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