[Intercostal abdominal hernias. Apropos of 2 cases with right hernia]

Abstract

Two patients presented with abdominal wall hernia in the 9th intercostal space on the right. Such localizations are extremely rare, occurring after closed or open chest or abdominal trauma producing two contiguous orifices in the diaphragm and the intercostal chest wall. The diaphragmatic orifice is due to a low lateral disinsertion and the intercostal orifice is situated in the 7th to 11th space, occurring immediately or later. Intercostal abdominal hernias are sometimes discovered due to pain or digestive or respiratory disorders. Clinical diagnosis is simple. CT scan confirms the clinical diagnosis and give a precise description. A direct or abdominal surgical approach is used to close the diaphragmatic orifice and the intercostal space with an unabsorbed suture. Muscle plasty or a unabsorbable prosthesis may be necessary. Early recurrence may occur if the orifice in the diaphragm is ignored.