Successful surgical rescue of delayed onset diaphragmatic hernia following radiofrequency ablation using a thoracoscopic approach for hepatocellular carcinoma: a case report

Surgical Case Reports

Katsunori Imai¹  Norio Uemura¹  Hiromitsu Hayashi¹  Atsushi Morito¹  Hirohisa Okabe¹  Yo-ichi Yamashita¹  Shigeki Nakagawa¹  Akira Chikamoto¹  Hideo Baba² 

[1] Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, 860-0811, Kumamoto, Japan;Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, 860-0811, Kumamoto, Japan;Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, 860-8556, Kumamoto, Japan;

关键词: Radiofrequency ablation;    Diaphragmatic hernia;    Thoracoscopy;    Hepatocellular carcinoma;   

DOI  :  10.1186/s40792-021-01213-8

来源: Springer

【 摘 要 】

BackgroundRadiofrequency ablation (RFA) is widely used as a minimally invasive treatment for hepatocellular carcinoma (HCC). RFA has a low risk of complications, especially compared with liver resection. Nevertheless, various complications have been reported after RFA for HCC; however, diaphragmatic hernia (DH) is extremely rare.Case presentationA 78-year-old man underwent thoracoscopic RFA for HCC located at the medial segment adjacent to the diaphragm approximately 7 years before being transported to the emergency department due complaints of nausea and abdominal pain. Computed tomography revealed a prolapsed small intestine through a defect in the right diaphragm, and emergency surgery was performed. The cause of diaphragmatic hernia was the scar of RFA. We confirmed that the small intestine had prolapsed into the right diaphragm, and we resected the necrotic small intestine and repaired the right diaphragm. Herein, we report a case of ileal strangulation due to diaphragmatic hernia after thoracoscopic RFA.ConclusionsCare should be taken when performing thoracoscopic RFA, especially for tumors located on the liver surface adjacent to the diaphragm. Patients should be carefully followed up for possible DH, even after a long postoperative interval.

【 授权许可】

CC BY