Abstract
We report a case of diaphragmatic hernia developing after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) that was successfully treated via a thoracotomy. In August 2009, an 83-year-old woman was admitted to our hospital with sudden onset of abdominal pain and dyspnea. She had undergone three sessions of RFA for HCC. A plain chest X-ray showed intestinal gas in the right thoracic cavity, with massive pleural effusion. Based on the diagnosis of diaphragmatic hernia, the patient underwent pleurocentesis. Surgery was performed via thoracotomy and laparotomy with small skin incisions. A large defect of the diaphragm was found, as well as a whitish-colored lesion of the liver after RFA 3 years earlier. There was no evidence of intestinal necrosis or bleeding. The defect was repaired by direct suture via an eighth intercostal thoracotomy. A small-thoracotomic approach may be a safe and useful option for the treatment of diaphragmatic hernia after RFA.
