Abstract
Percutaneous radiofrequency ablation (RFA) is widely used as an effective treatment of liver tumors. Several reported complications associated with RFA are due to thermal damage of neighboring organs. The present report presents a case of diaphragmatic hernia associated with RFA and hepatocellular carcinoma (HCC). A 72-year-old woman with S5 and S8 HCCs was treated repeatedly with RFA and transcatheter arterial chemoembolization for 3 years. After the third course of RFA to target the recurring S5 HCC, acute abdominal pain and dyspnea suddenly occurred. Contrast-enhanced computed tomography revealed intrusion of the transverse colon through the right diaphragmatic hernia. In addition, the colon was dilated and showed changes suggestive of ischemic conditions. An emergency surgery was performed to close the hernia by using non-absorbable sutures to preserve the colon. The patient was discharged without any complications 13 days after the surgery. The first-line treatment of this disease involves surgical intervention. Diaphragmatic hernia is a rare complication of RFA. The present case suggests that patients who undergo several rounds of RFA require surveillance for diaphragmatic hernias.
Highlights
The incidence of hepatocellular carcinoma (HCC) has been increasing worldwide, making HCC one of the most common malignant tumors [1]
Liver resection provides enhanced long-term survival, with a 5-year overall survival rate of around 60 % [2, 3]. These results are reflected by developments in the surgical techniques and perioperative management approaches for HCC
In 2011, she was diagnosed with hepatitis C virus-related liver cirrhosis (Child-Pugh grade B) and HCC
Summary
The incidence of hepatocellular carcinoma (HCC) has been increasing worldwide, making HCC one of the most common malignant tumors [1]. Liver resection provides enhanced long-term survival, with a 5-year overall survival rate of around 60 % [2, 3] These results are reflected by developments in the surgical techniques and perioperative management approaches for HCC. The surgical approach could depend on the timing of the surgery and the association with other organ intrusions of the hernia, making it difficult to obtain a working space for laparoscopic repair. According to liver function and tumor stage, percutaneous treatment is selected for local liver tumors; its efficacy could not match to that of Preventing this complication is impossible, but early diagnosis is possible by meticulous follow-up. As diaphragmatic hernia requires surgical repair, recent reports demonstrated that laparoscopic simple closure is effective [7]. Surgical repair is required to prevent intestinal intrusion
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