title: Diaphragm rupture in a liver transplant patient under chronic immunosuppressive therapy with sirolimus: rare complication after liver transplantation.
abstract: A diaphragm rupture is a very rare event. A variety of conditions such as coughing, delivery, and vigorous exercise causing a sudden increase of the intra-abdominal pressure can result in diaphragm rupture [1]. The diagnosis can be difficult because of non-specific symptoms and no history of blunt or penetrating trauma. Due to anatomical reasons, diaphragmatic lesions in the left side are more common than those in the right side. Chronic immunosuppressive therapy in transplanted patients, especially with antiproliferative drugs such as mTOR inhibitor, has been considered as a risk factor for the development of incisional hernia [2, 3]. We present the case of diaphragm rupture in a liver transplant patient under chronic immunosuppressive therapy with sirolimus.
authors.affiliation: Department of Surgery and Transplantation, University Hospital of Udine, P. Le S.M. della Misericordia, Italy. rossettoannaar@libero.it
authors.forename: Anna
authors.initials: A
authors.lastname: Rossetto
authors.forename: Umberto
authors.initials: U
authors.lastname: Baccarani
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Adani
authors.forename: Dario
authors.initials: D
authors.lastname: Lorenzin
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bresadola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Terrosu
mesh_terms: D003937:Diagnosis, Differential; D006548:Hernia, Diaphragmatic / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012421:Rupture; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus