Cough induced rib fracture, rupture of the diaphragm and abdominal herniation.docVIP

World Journal of Emergency Surgery BioMedCentral Case report Open Access Cough induced rib fracture, rupture of the diaphragm and abdominal herniation Andreas Hillenbrand*, Doris Henne-Bruns and Peter Wurl Address: Universitiy of Ulm, Department of Viszeral – and Transplantation surgery, Steinh?velstr. 9, 89070 Ulm, Germany Email: Andreas Hillenbrand* - Andreas.Hillenbrand@medizin.uni-ulm.de; Doris Henne-Bruns - Andreas.Hillenbrand@medizin.uni-ulm.de; Peter Wurl - Andreas.Hillenbrand@medizin.uni-ulm.de * Corresponding author Published: 24 November 2006 Received: 18 October 2006 Accepted: 24 November 2006 World Journal of Emergency Surgery 2006, 1:34 doi:10.1186/1749-7922-1-34 This article is available from: /content/1/1/34 ? 2006 Hillenbrand et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of the diaphragm, and an abdominal wall herniation. The hernia was repaired through surgical treatment without bowel resection, the diaphragm and the internal and oblique abdominal muscle were adapted, and the abdomen was reinforced with a prolene net. Although each individual injury is well documented in the literature, the combination of rib fracture, abdominal herniation and diaphragm rupture has not been reported. Case report a surrounding haematoma and hematothorax; however, no bowel herniation or muscle tear was evident (Fig. 1, 2). A thoracic drain was inserted for two days. During the hospital stay the patients abdomen became meteoristic and painful. He had no bowel movements for f