BMJ Case Reports 2018; doi:10.1136/bcr-2018-227158
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Laparoscopic IPOM repair of an acquired abdominal intercostal hernia

  1. Iqbal Z Khan
  1. General Surgery, Mayo General Hospital, Castlebar, Ireland
  1. Correspondence to Dr Muhammad Qais Luqman, qais_luqman{at}
  • Accepted 16 October 2018
  • Published 3 November 2018


Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk. Recently, laparoscopic and robot-assisted repairs have been proposed. We discuss a 49-year-old man presented through outpatient setting with a 5-year history of ongoing left subcostal discomfort and a reducible lump. His history included a workplace accident 5 years ago. Contrast-enhanced abdominal CT confirmed AAIH with omentum herniation into the sac. A successful laparoscopic repair with intraperitoneal onlay mesh technique using composite mesh was performed.


  • Contributors MQL is the corresponding author of this case report with the main concept and design. IZK is my supervisor who played a pivotal role not only in the selection of the case but in almost every step of preparation of this case report. He took the particular interest in the design and final draft of this case report as well. I am indebted to his contribution. AAM one of my fine senior colleagues helped a lot for the case discussion, various case report selection and writing up this case report. AAM contributed through the interpretation of the data but also critical analysis of this case report. RW gave his expert advice about the conception, acquisition of data and critical analysis of the final case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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