Congenital partial chest wall defect with extracorporeal intercostal liver herniation

Abstract

Congenital herniation of the liver through the chest wall associated with chest wall deformity is an extremely rare clinical observation. There are only a few reports of intercostal liver herniation associated with Poland syndrome, which is characterized by hypoplastic unilateral chest wall structures. We present a case of a neonate with a mass drooping through a defect in the left side of the chest wall with diaphragmatic eventration. The patient demonstrated a left-sided hypoplastic pectoralis musculature defect and an ipsilateral costal cartilage defect in the left side of the sternum at the level of the fifth to sixth ribs. The radiological investigation revealed that the mass was a result of herniation of the left lobe of the liver. On the day after birth, resection of the mass was performed by laparotomy because the color of the mass gradually changed to a dark red appearance, and incarceration and necrosis were suspected. There were no intraoperative or postoperative complications. Postoperatively, the diaphragm was concluded to have normal movement on radioscopic examination.