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Wall Surg."],"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To present a rare and complex case of a spontaneous intercostal, transdiaphragmatic and abdominal wall hernia in an elderly male with a history of chronic obstructive pulmonary disease (COPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>According to the CARE checklist, we describe a rare case of intercostal, transdiaphragmatic and abdominal wall hernia after an episode of severe coughing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 72-year-old male presented with nausea, dyspnea, and progressive left thoracic and abdominal swelling, along with a history of severe cough and spontaneous hematoma in the same regions. A CT scan revealed an intercostal hernia between the 8th and 9th ribs, with transdiaphragmatic extension and involvement of the lateral abdominal wall, containing most of the stomach, transverse colon, splenic flexure, descending colon, and small intestine. An elective left thoraco-abdominal open surgery was performed, including preperitoneal hernioplasty with dual mesh placement and repair of the diaphragmatic and costal defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Such cases are scarcely reported in the literature. This case highlights the importance of considering complex hernia in patients with severe COPD and the importance of early treatment along with a multidisciplinary surgical approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/jaws.2025.14535","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T06:00:27Z","timestamp":1751608827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Combined Intercostal-Transdiaphragmatic-Abdominal Wall Hernia"],"prefix":"10.3389","volume":"4","author":[{"given":"P.","family":"Mart\u00ednez-L\u00f3pez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Verdaguer-Tremolosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Rodrigues-Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Mart\u00edn-Del-Rey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"L\u00f3pez-Cano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1007\/s10029-012-0902-9","article-title":"An Enigma of Spontaneous Combined Transdiaphragmatic, Intercostal and Abdominal Wall Hernia","volume":"17","author":"Abu-Gazala","year":"2013","journal-title":"Hernia : J hernias Abdom wall Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1111\/j.1440-1673.2006.01661.x","article-title":"Acquired Spontaneous Intercostal Abdominal Hernia: Case Report and a Comprehensive Review of the World Literature","volume":"51","author":"Unlu","year":"2007","journal-title":"Australas Radiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s10029-014-1232-x","article-title":"Acquired Abdominal Intercostal Hernia: Case Report and Systematic Review of the Literature","volume":"18","author":"Erdas","year":"2014","journal-title":"Hernia : J hernias Abdom wall Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1097\/SLE.0b013e31817f2883","article-title":"Endoscopic Repair of an Abdominal Intercostal Hernia","volume":"18","author":"Bobbio","year":"2008","journal-title":"Surg Laparosc Endosc and percutaneous Tech"},{"key":"B5","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1097\/TA.0000000000004068","article-title":"Costal Margin Injuries and Trans-diaphragmatic Intercostal Hernia: Presentation, Management and Outcomes According to the Sheffield Classification","volume":"95","author":"Byers","year":"2023","journal-title":"The J Trauma acute Care Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1093\/ejcts\/ezz020","article-title":"Unifying Classification for Transdiaphragmatic Intercostal Hernia and Other Costal Margin Injuries","volume":"56","author":"Gooseman","year":"2019","journal-title":"Eur J cardio-thoracic Surg : official J Eur Assoc Cardio-thoracic Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00063110-200502000-00013","article-title":"Spontaneous Rupture of the Diaphragm","volume":"12","author":"Gupta","year":"2005","journal-title":"Eur J Emerg Med : official J Eur Soc Emerg Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.ejcts.2010.05.040","article-title":"Spontaneous Abdominal--Intercostal Hernia","volume":"39","author":"Ampollini","year":"2011","journal-title":"Eur J cardio-thoracic Surg : official J Eur Assoc Cardio-thoracic Surg"},{"key":"B9","first-page":"92","article-title":"Transdiaphragmatic Intercostal Hernia Due to Chronic Cough","volume":"25","author":"Khan","year":"2006","journal-title":"Indian J Gastroenterol : official J Indian Soc Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s10029-004-0249-y","article-title":"Traumatic Abdominal Hernia Caused by Cough, Presenting with Intestinal Obstruction","volume":"8","author":"Lund","year":"2004","journal-title":"Hernia : J hernias Abdom wall Surg"},{"key":"B11","first-page":"138","article-title":"La hernie intercostale abdominale. 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