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Published on: September 20, 2020
Thoracic complications of radiofrequency ablation of recurrent hepatoma
Jia Lin Soon1, Prema Raj Jeyaraj, T Agasthian
1Department of Cardiothoracic Surgery, National Heart Centre, Singapore. soon.jia.lin@singhealth.com.sg
Introduction:
Radiofrequency ablation (RFA) for unresectable primary or secondary hepatic malignancies have gained widespread availability and acceptance over the past 5 years. Complication rates have been reported to range from 0% to 27%.
Clinical Picture:
We report a patient with symptomatic right pleural effusion due to a diaphragmatic fistula and another with biliptysis post-RFA, for recurrent hepatoma.
Treatment:
Percutaneous drainage of both the pleural effusion and biloma was performed. However, surgical repair of the diaphragmatic fistula was only required for the former for persistent drainage.
Outcome:
Both patients were successfully treated with minimal morbidity.
Conclusion:
High index of suspicion is required for the early diagnosis and treatment of diaphragmatic fistulas. Simple catheter drainage can potentially obviate the need for surgery.
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