Kim Jong Sun, Kim Hyoung Sang, Myung Dae Sung, Lee Gi Hoon, Park Kang Jin, Cho Sung Bum, Joo Young Eun, Choi Sung Kyu
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Korean J Gastroenterol. 2013 Sep;62(3):174-8. doi: 10.4166/kjg.2013.62.3.174.
Because of its safety and treatment effectiveness, the popularity of radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) has gradually increased. However, some serious complications of RFA such as hepatic infarction, bowel perforation, and tumor seeding have been reported. Recently, we experienced a case of diaphragmatic hernia after RFA for HCC. A 61-year-old man with alcoholic cirrhosis was diagnosed with a 1.0 cm sized HCC in segment (S) 5 and a 1.3 cm sized HCC in S 8 of the liver. He was treated by transarterial chemoembolization and RFA. After RFA, an abdominal CT revealed a diaphragmatic defect with herniating mesentery. Twenty-two months after the RFA, the chest CT showed the diaphragmatic defect with herniating colon and mesentery. Because he had no symptoms, and surgical repair for the diaphragmatic hernia would be a high risk operation for him, we decided to treat the patient conservatively. For its great rarity, we report this case with a review of the literature.
由于其安全性和治疗效果，射频消融（RFA）治疗肝细胞癌（HCC）的普及程度逐渐提高。然而，已有报道称RFA会出现一些严重并发症，如肝梗死、肠穿孔和肿瘤种植。最近，我们遇到了一例肝癌RFA术后发生膈疝的病例。一名61岁的酒精性肝硬化男性被诊断为肝脏第5段有一个1.0 cm大小的肝癌，第8段有一个1.3 cm大小的肝癌。他接受了经动脉化疗栓塞和RFA治疗。RFA术后，腹部CT显示有膈肌缺损伴肠系膜疝出。RFA术后22个月，胸部CT显示膈肌缺损伴结肠和肠系膜疝出。由于他没有症状，而且对他来说膈疝手术修复将是一项高风险手术，我们决定对该患者进行保守治疗。鉴于其极为罕见，我们报告此病例并复习相关文献。
