title: Diaphragmatic necrosis after radiofrequency ablation of hepatocellular carcinoma: a successful surgical repair.
abstract: We report a case of complete hemidiaphragmatic necrosis with liver abscess complicating radiofrequency ablation of a large subdiaphragmatic hepatocellular carcinoma in a patient with unrecognized history of endoscopic oddi sphincterotomy. At 2-year follow-up after surgical repair using a pedicled latissimus dorsi flap, clinical examination and imaging did not show complication or cancer recurrence. The risk of complete hemidiaphragmatic necrosis resulting from both thermal and septic injuries should be considered when radiofrequency ablation is performed for liver dome tumors, particularly in patients with impaired oddi sphincter. In this septic situation, a latissimus dorsi flap appears as the unique opportunity to repair the injured hemidiaphragm.
authors.affiliation: Université Paris 13, UPRES Sorbonne Paris Cité, 93206 Saint-Denis, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Kanso
authors.forename: Pierre
authors.initials: P
authors.lastname: Nahon
authors.forename: Dominique
authors.initials: D
authors.lastname: Blaison
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Trinchet
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
authors.forename: Olivier
authors.initials: O
authors.lastname: Seror
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Martinod
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D003964:Diaphragm / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008100:Liver Abscess / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D009336:Necrosis / Q000209:etiology / Q000601:surgery; D016717:Sphincterotomy, Endoscopic; D013524:Surgical Flaps