Doctors are warning of the dangers of chronic cough after treating a man who broke a rib from chopping hard.
The 54-year-old patient had to have part of his bone removed and replaced with a metal rod because the broken rib was not healing properly and was pressing against a nerve in his chest.
The unnamed man, originally from Italy, was a heavy smoker who had been involved in an accident years earlier that had weakened his rib cage.
In 2023, he suffered from multiple coughing fits that landed him in the emergency room, but the pain became so unbearable that he underwent surgery in September of last year.
The man had broken his left 8th rib bone in half and the constant coughing was preventing it from healing. Bone tissue was pressing against a nerve in his chest, causing excruciating pain
Chunks of bone tissue had formed a solidified mass between his broken bone. It was removed to relieve the pressure (pictured above)
Scans showed he had broken the eighth rib on his left side, leaving a four-centimetre hole in the centre of the bone.
It had not healed properly, partly because the patient was constantly coughing, which had caused pieces of bone tissue to form into a coagulated mass.
This tissue mass pressed against the intercostal nerves, which run along the ribs, chest, and stomach.
Surgeons made a small incision in his chest and removed the excess bone, which relieved pressure on the nerve and should reduce the patient’s pain.
The team then inserted a thin, three-centimeter-long metal screw rod, called a splint, to hold the broken rib together.
Within 24 hours of surgery, the patient was completely pain free and six weeks later he was still symptom free.
Are story was revealed in the American Journal of Case Reports by surgeons in Milan who operated on him.
The doctors wrote in the report: ‘A 54-year-old man presented with chronic cough-induced left chest wall pain.
‘…scan showed a non-union of a fracture of the left posterior 8th rib. After failure of medical treatment, we proposed a surgical approach with the aim of removing the tissue surrounding the non-union, releasing the nerve and stabilizing the bone stumps.’
They added: ‘The pain disappeared immediately after surgery. The patient was discharged within 24 hours.
‘At a follow-up examination after six weeks, he was still asymptomatic and a new CT scan confirmed the correct position of the splint.
‘From the immediate postoperative evaluation through the last follow-up visit, he consistently indicated that he was very satisfied.’
The team was relieved that the patient did not require pain medication at his follow-up visit, as he had become addicted to prescription opioids after a previous hospital visit.
It was discovered that the patient suffered from a vitamin D deficiency, which can weaken bones and lead to the bone disease osteoporosis. Both conditions increase the risk of serious bone fractures.
Doctors advise you to see your doctor if you have a cough that lasts for weeks, especially if your cough produces mucus or blood, disrupts your sleep, or if it affects school or work.