title: Late-onset diaphragmatic hernia after percutaneous radiofrequency ablation of hepatocellular carcinoma: a case study.
abstract: Percutaneous radiofrequency ablation (RFA) is widely used as an effective treatment of liver tumors. Several reported complications associated with RFA are due to thermal damage of neighboring organs. The present report presents a case of diaphragmatic hernia associated with RFA and hepatocellular carcinoma (HCC). A 72-year-old woman with S5 and S8 HCCs was treated repeatedly with RFA and transcatheter arterial chemoembolization for 3 years. After the third course of RFA to target the recurring S5 HCC, acute abdominal pain and dyspnea suddenly occurred. Contrast-enhanced computed tomography revealed intrusion of the transverse colon through the right diaphragmatic hernia. In addition, the colon was dilated and showed changes suggestive of ischemic conditions. An emergency surgery was performed to close the hernia by using non-absorbable sutures to preserve the colon. The patient was discharged without any complications 13 days after the surgery. The first-line treatment of this disease involves surgical intervention. Diaphragmatic hernia is a rare complication of RFA. The present case suggests that patients who undergo several rounds of RFA require surveillance for diaphragmatic hernias.
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Takechi
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Fujikuni
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Tatsunari
authors.initials: T
authors.lastname: Sasada
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamaki
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakahara
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan. nori0509@hotmail.co.jp.|Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. nori0509@hotmail.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Noriyuki
keywords: Diaphragmatic hernia; Hepatocellular carcinoma; Radiofrequency ablation