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: Frederic Kanso, Pierre Nahon, Dominique Blaison, Jean-Claude Trinchet, Michel Beaugrand, Olivier Seror, Emmanuel Martinod
• Journal: Clinics and research in hepatology and gastroenterology (Clin Res Hepatol Gastroenterol) Vol. 37 Issue 2 Pg. e59-63 (Apr 2013) ISSN: 2210-741X [Electronic] France
• PMID: 23137756 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Topics

• Aged
• Carcinoma, Hepatocellular (surgery)
• Catheter Ablation (adverse effects)
• Diaphragm (pathology, surgery)
• Humans
• Liver Abscess (etiology)
• Liver Neoplasms (surgery)
• Male
• Necrosis (etiology, surgery)
• Sphincterotomy, Endoscopic
• Surgical Flaps