A case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with herniation of lung – A very rare entity

Herein we report a case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with lung herniation in an elderly gentleman with Chronic Obstructive Pulmonary Disease (COPD). Initially he presented with severe cough followed by pain and small fluctuating swelling over the right chest wall. In-patient investigations were suggestive of hemothorax without any chest wall abnormality. Later the swelling gradually increased to a significant size for which he was further evaluated. Detailed imaging studies revealed it was a case of spontaneous intercostal hernia of bowel loops and omentum with herniation of lung. The patient is kept under regular follow up for optimization for his obstructive airway component for the required surgical repair of the parietal defect.