Laparoscopic Repair and Relief of Obstruction of a Diaphragmatic Hernia after Percutaneous Radiofrequency Ablation: A Case Report

Miura Satomi, Ito Kyoji, Takemura Nobuyuki, Mihara Fuminori, Deguchi Katsuya, Kiyomatsu Tomomichi, Kokudo Norihiro

doi:10.4030/jjcs.47.66

<p>A 70-year-old man with alcoholic liver cirrhosis had undergone four sessions of radiofrequency ablation (RFA) for the treatment of recurrent liver cancer. Nine months after the final session of RFA (which had been performed to treat a lesion in S8), the patient was referred to our hospital with complaints of cough and right upper quadrant abdominal pain. On admission, laboratory data showed increased inflammatory markers, and imaging examination revealed dilated loops of small intestine in the right upper abdomen and an infiltrative opacity in the lower right lobe of the lung, along with a right pleural effusion. On the basis of these findings, we diagnosed the patient as having ileus and aspiration pneumonia, and treated him with antibiotics and gastric tube insertion. However, the symptoms only worsened steadily, and on day 8 of admission, the patient developed fever (38℃) and increase in the levels of inflammatory markers. Contrast-enhanced computed tomography revealed a right diaphragmatic hernia with incarceration of the small intestine. Emergency laparoscopy was performed to repair the hernia and relieve the obstruction of the incarcerated bowel in the diaphragmatic hernia. Herein, we present a rare case of a patient who developed diaphragmatic hernia complicating transdiaphragmatic RFA for S8 liver cancer and was treated by a laparoscopic approach, along with a discussion of the relevant literature.</p>

Laparoscopic Repair and Relief of Obstruction of a Diaphragmatic Hernia after Percutaneous Radiofrequency Ablation: A Case Report

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