alexa Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report

Yusuke Yamamoto1*, Teiichi Sugiura1, Yukiyasu Okamura1, Takaaki Ito1, Ryo Ashida1, Yoshiyasu Kato1, Katsuhisa Ohgi1, Mihoko Yamada1, Rui Sato2, Takeshi Aramaki2, and Katsuhiko Uesaka1

1Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan

2Division of Radiology, Shizuoka Cancer Center, Shizuoka, Japan

*Corresponding Author:
Yusuke Yamamoto
Division of Hepato-Biliary- Pancreatic Surgery
Shizuoka Cancer Center, Shizuoka, Japan
Tel: +81559895222
Fax: +81559895783
E-mail: [email protected]

Received Date: April 23, 2017 Accepted Date: May 24, 2017 Published Date: May 28, 2017

Citation: Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R, et al. (2017) Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report. J Clin Case Rep 7: 960. doi: 10.4172/2165-7920.1000960

Copyright: © 2017 Yamamoto Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Diaphragmatic hernia is a rare complication after hepatic radiofrequency ablation (RFA). We herein present a case of a patient who underwent laparoscopic repair of diaphragmatic perforation with colonic herniation occurring 12 months after hepatic RFA.

Case presentation: An 80-year-old man underwent RFA under computed tomography guidance using a cool-tip radiofrequency probe with a short trans-thoracic root for hepatocellular carcinoma in segment VIII. Twelve months later, he developed a large amount of right pleural effusion and a right diaphragmatic hernia containing the colon and mesentery. After drainage of the right pleural effusion, the patient underwent laparoscopic repair of the diaphragmatic perforation with colonic herniation. Severe adhesion was noted between nearly the entire herniated colon and lung; however, we were able to remove the herniated colon from the thoracic cavity safely. Bowel resection was not required. Finally, simple running sutures of the diaphragmatic defect using 2-0 Vicryl were laid down. There were no postoperative complications, and the patient was discharged nine days after surgery.

Conclusions: Diaphragmatic hernia is rare but should be recognized as a late complication following hepatic RFA. Surgical repair of a diaphragmatic hernia, including minimally invasive surgery using the laparoscopic approach, especially for patients with cirrhosis, should be considered in order to avoid acute intestinal obstruction or perforation.

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