CTICasesPost-Radiofrequency Ablation Diaphragmatic Hernia
[...]. Post-Radiofrequency Ablation Diaphragmatic Hernia. CTICases. Published May 5, 2017. https://str-case-explorer.pages.dev/c/x82qa
Imaging findings
Multi-detector CT scans obtained several years apart in a patient who underwent radiofrequency ablation (RFA) for a right-lobe hepatocellular carcinoma demonstrate a progressive right hemidiaphragmatic defect. Over time, there is increasing herniation of extraperitoneal fat and a portion of the liver through the diaphragmatic defect into the right hemithorax.
Key takeaways
Diaphragmatic injury and subsequent hernia formation is a rare but recognized complication of thermal ablation (such as RFA or microwave ablation) of subdiaphragmatic hepatic tumors. Thermal energy can damage the muscular fibers of the adjacent diaphragm, leading to necrosis and a focal defect that can slowly enlarge over time under the influence of positive intra-abdominal and negative intrathoracic pressure.
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