1547 - The Development of Pseudohernia following Intercostal Nerve Injury: A Case Series

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Co-Author(s)

KA

Keeghan Andrews, BS

Medical Student
Medical University of South Carolina
Charleston, South Carolina, United States

Presenting Author(s)

KG

Kristen Gambardella, BS

Medical Student
Medical University of South Carolina
Charleston, South Carolina, United States

Co-Author(s)

DD

Dane Daley, MD

Physician
Medical University of South Carolina
Charleston, South Carolina, United States
EE

Evert Eriksson, MD

Physician
Medical University of South Carolina
Charleston, South Carolina, United States

Corresponding Author(s)

MS

Matthew Sherrier, MD

Physician
Medical University of South Carolina
Charleston, South Carolina, United States

Submitter(s)

KG

Kristen Gambardella, BS

Medical University of South Carolina
Charleston, South Carolina, United States

Case Diagnosis: Pseudohernia secondary to intercostal nerve injury

Case Description: Pseudohernias - herniation of abdominal contents without disruption of the abdominal wall - can occur after intercostal nerve damage and subsequent denervation of the abdominal wall musculature. Five patients with pseudohernias secondary to nerve conduction study (NCS)/electromyography (EMG)-diagnosed intercostal neuropathy were included in the case series. Ultrasound measurements of rectus abdominis cross sectional thickness were documented to assess for atrophy. Etiologies of the intercostal nerve injury were varied as follows: displaced rib fracture, intercostal nerve cryoablation, thoracic spinal stenosis, lobectomy, and thoracolumbar fusion with corpectomy.

Discussions: Intercostal NCS/EMG can reliably diagnose and localize intercostal nerve injuries. The average patient age was 65 years and body mass index was 26.35 kg/m². Ultrasound measurements at the level of intercostal neve injury demonstrated an average rectus abdominis transverse cross-sectional thickness of 0.69 cm on the affected side, compared with 1.09 cm on the non-affected side with a statistically significant difference (p=0.003).

Conclusions: Intercostal nerve injury can result in denervation of the abdominal musculature resulting in atrophy, pain, cosmetic issues, and eventual development of a pseudohernia. Pseudohernias are a largely underrecognized sequela of intercostal nerve injury. The present case series highlights 5 different etiologies for intercostal neuropathy, the development of pseudohernias, and further demonstrates the utility of electrodiagnostic testing for diagnosing intercostal nerve injuries.