Related Experiment Video
Updated: Jul 21, 2025
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Double closed loop small bowel obstruction due to right diaphragmatic hernia after transcatheter arterial
Noppachai Siranart1, Manichaya Sukonpatip2, Walit Sowalertrat2,3
1Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873, Rama 4 Rd., Lumphini, Bangkok, 10330, Thailand. siranartnoppachai@gmail.com.
Abstract:
64-Year-old male patient with hepatocellular carcinoma (HCC), liver cirrhosis, chronic hepatitis C infection, and glottic cancer presented with acute progressive abdominal pain and palpable mass in right upper quadrant of the abdomen. Despite treatment with hyoscine and tramadol, the symptoms persisted. He had received three sessions of Transcatheter arterial chemoembolization (TACE) and two sessions of microwave ablation (MWA) for HCC treatment, with the last session being TACE 11 months prior. Plain film abdomen showed bowel gas pattern in the right hemithorax compatible with bowel obstruction. CT imaging revealed a right diaphragmatic hernia containing closed loop small bowel obstruction. An emergency exploratory laparotomy was performed. The patient improved and was discharged. There was no recurrence of diaphragmatic hernia or abdominal mass or pain at the 6-month follow-up visit. We herein demonstrate a catastrophic complication of TACE by using an IPA and MWA which leads to right diaphragmatic hernia.
