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Related Concept Videos

Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...

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Diaphragmatic Hernia after Radiofrequency Ablation.

Asahiro Morishita1, Joji Tani1, Tsutomu Masaki1

  • 1Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe Miki-cho, Kita-gun, Kagawa 761-0793, Japan.

Diagnostics (Basel, Switzerland)
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Summary

A diaphragmatic hernia (DH) occurred in a patient after hepatocellular carcinoma treatment. This acquired DH resulted from a percutaneous radiofrequency ablation procedure, highlighting a rare complication.

Keywords:
diaphragmatic herniaendoscopic procedureradiofrequency ablation

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Diaphragmatic hernia (DH) can be congenital or acquired.
  • Acquired DH risk factors include trauma and surgical procedures.
  • Hepatocellular carcinoma (HCC) treatment involves various interventions.

Purpose of the Study:

  • To report a rare case of acquired diaphragmatic hernia.
  • To highlight a potential complication of percutaneous radiofrequency ablation (RFA) for HCC.
  • To discuss the management of iatrogenic diaphragmatic injury.

Main Methods:

  • Case report of a 71-year-old male patient.
  • Patient underwent endoscopic treatment for esophageal varices.
  • Diagnosis of DH was made after severe vomiting and abdominal pain post-procedure.
  • Surgical fixation of the diaphragmatic injury was performed.

Main Results:

  • The diaphragmatic injury was located at the needle track of a prior percutaneous RFA.
  • The RFA was performed for HCC through the thoracic diaphragm with artificial pleural effusion.
  • The patient experienced severe vomiting and upper abdominal pain, leading to DH diagnosis.

Conclusions:

  • Percutaneous procedures through the diaphragm carry a risk of iatrogenic injury.
  • Diaphragmatic injury should be considered in patients presenting with abdominal pain post-interventional procedures.
  • Prompt surgical intervention is necessary for managing acquired diaphragmatic hernias.