title: Non-traumatic trans-diaphragmatic intercostal hernia and cor pulmonale in a patient with poorly controlled obstructive sleep apnoea.
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.
authors: Lancashire Teaching Hospitals, Preston, Lancashire, UK.
authors: Syed Basharath
authors: SB
authors: Mehdi
authors: Department of Respiratory, Royal Albert Edward Infirmary, Wigan, UK.
authors: Salem
authors: S
authors: Madi
authors: Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
authors: Jordan
authors: J
authors: Sudworth
mesh_terms: D000368:Aged; D006333:Heart Failure / Q000150:complications; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011660:Pulmonary Heart Disease / Q000150:complications*; D012121:Respiration, Artificial / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy; D035441:Thoracic Wall