Abstract
A 77-year-old man was referred to our department because of an abnormal nodule in the right lower lobe on a chest CT scan at a medical checkup. Lung cancer (cT1bN0M0, stage IA2) was suspected. We performed video assisted right lower lobectomy with lymph node dissection by placing each two ports in the right fifth intercostal and in the right seventh intercostal spaces, respectively. His postoperative course was almost uneventful, however, on the 9th postoperative day, he suddenly had a sense of discomfort at the right thoracic region, and aggravation of bloody sputum and a fist-sized bulge just under the 5th intercostal wound were demonstrated. A chest CT scan revealed a part of the middle lobe to have herniated through the fifth intercostal space as a hernia orifice. The lung parenchyma could be reduced manually. We directed him the way to give continuous compression using a chest band as well as to compress the hernia orifice at coughing. Thereafter no recurrence of intercostal herniation occurred and the patient was discharged from our hospital without re-operation. Further recurrence of intercostal hernia has not occurred, as of 2 years after the operation.
