Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Case Report of a Simple Rib Fracture Caused by Coughing

기침으로 초래된 단순 늑골골절 1례

  • Choi, Woo-Ik (Department of Emergency Medicine, School of Medicine, Keimyung University, Dongsan Medical Center)
  • 최우익 (계명대학교 의과대학 동산의료원 응급의학과)
  • Received : 2013.11.27
  • Accepted : 2014.04.21
  • Published : 2014.03.31
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Abstract

Violent or severe persistent coughing is rarely associated with rib fracture. We report a rare case of a cough-induced rib fracture in a patient without any traumatic history or any other underlying disease. A 32-year-old female presented to the emergency department complaining of having had right-sided pleuritic chest pain for 5 days. She had a background of an 8-week coughing illness. A posteroanterior view of the chest radiograph showed no definite fractured line. Chest computed tomography revealed a subtle break cortical line of the 7th rib in the right-sided chest wall. Early identification of a cough-induced fracture of the rib by using computed tomography may avoid unnecessary further work-ups including laboratory examination and may lead to appropriate discharge instructions including rest and reassurance. The clinical presentations and radiologic findings of rib fractures caused by coughing are presented along with a review of the literature.

Keywords

References

  1. Roberge RJ, Morgenstern MJ, Osborn H. Cough fracture of the ribs. Am J Emerg Med. 1984; 2: 513-7. https://doi.org/10.1016/0735-6757(84)90077-9
  2. Begley A, Wilson DS, Shaw J. Cough fracture of the first rib. Injury. 1995; 26: 565-6. https://doi.org/10.1016/0020-1383(95)00098-T
  3. Yeh CF, Su SC. Cough-induced rib fracture in a young healthy man. J Formos Med Assoc. 2012; 111: 179-80. https://doi.org/10.1016/j.jfma.2011.07.020
  4. Even-Tov I, Yedwab GA, Persitz E, David MP. Stress fracture of ribs in late pregnancy. Int Surg. 1979; 64: 85-7.
  5. Prasad S, Baur LA. Fracture of the first rib as a consequence of pertussis infection. J Paediatr Child Health. 2001; 37: 91-3. https://doi.org/10.1046/j.1440-1754.2001.00568.x
  6. Kawahara H, Baba H, Wada M, Azuchi M, Ando M, Imura S. Multiple rib fractures associated with severe coughing--a case report. Int Orthop. 1997; 21: 279-81. https://doi.org/10.1007/s002640050168
  7. De Maeseneer M, De Mey J, Debaere C, Meysman M, Osteaux M. Rib fractures induced by coughing: an unusual cause of acute chest pain. Am J Emerg Med. 2000; 18: 194-7. https://doi.org/10.1016/S0735-6757(00)90019-6
  8. Kim YH, Hwang EG, Lee SA, Lee JW, Lee CH, Choi YC. Disclosure of Unnoticed rib Fractures with the use of Ultrasonography in Minor Blunt Chest Trauma Journal of the korean society of traumatology. 2004; 17: 74-80.
  9. Daniel R, Naidu B, Khalil-Marzouk J. Cough-induced rib fracture and diaphragmatic rupture resulting in simultaneous abdominal visceral herniation into the left hemithorax and subcutaneously. Eur J Cardiothorac Surg. 2008; 34: 914-5. https://doi.org/10.1016/j.ejcts.2008.06.048