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      Non-traumatic trans-diaphragmatic intercostal hernia and cor pulmonale in a patient with poorly controlled obstructive sleep apnoea

      case-report
      1 , 2 , 3
      BMJ Case Reports
      BMJ Publishing Group

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          Abstract

          Trans-diaphragmatic intercostal hernia is a rare entity. Patient with multiple medical comorbidities, including obstructive sleep apnoea, presents with shortness of breath, leg oedema and a bulging swelling through the right chest wall. CT shows partial herniation of the right lung and liver through intercostal space and an echocardiogram reveals right heart failure. He was treated initially with continuous positive airway pressure with poor response and subsequently treated with adaptive servo ventilation with much better symptomatic relief and treatment tolerance.

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          Author and article information

          Journal
          BMJ Case Rep
          BMJ Case Rep
          casereports
          bmjcasereports
          BMJ Case Reports
          BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
          1757-790X
          2016
          28 October 2016
          : 2016
          : bcr2016216841
          Affiliations
          [1 ] Lancashire Teaching Hospitals , Preston, Lancashire, UK
          [2 ] Department of Respiratory, Royal Albert Edward Infirmary , Wigan, UK
          [3 ] Wrightington, Wigan and Leigh NHS Foundation Trust , Wigan, UK
          Author notes
          [Correspondence to ] Dr Salem Madi, salem.madi@ 123456wwl.nhs.uk
          Article
          PMC5093801 PMC5093801 5093801 bcr-2016-216841
          10.1136/bcr-2016-216841
          5093801
          27793867
          99ba1812-2308-4092-bd80-9df74d98c246
          2016 BMJ Publishing Group Ltd
          History
          : 17 October 2016
          Categories
          Article
          Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)
          1522
          1625
          Male
          51-70 years
          White
          United Kingdom
          Case Report

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