CTICasesTraumatic Lateral Intercostal Hernia and Diaphragmatic Tear
Imaging findings
Initial chest radiography was unremarkable, but a subsequent film showed a lucency in the right lower chest. CT demonstrated a lateral intercostal hernia, with bowel loops protruding through a defect between the ribs, and an associated T-shaped tear in the diaphragm. These findings were observed following a motor vehicle crash.
Key takeaways
Traumatic lateral intercostal hernias are rare and can be associated with diaphragmatic tears following blunt trauma. While often subtle on initial radiographs, a new focal lucency in the chest wall or diaphragm should raise suspicion. CT provides detailed visualization of the herniated contents and the diaphragmatic defect. Such injuries are typically associated with high-impact trauma, distinct from iatrogenic hernias post-thoracotomy.
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