CTICasesIncarcerated Diaphragmatic Gastric Hernia post Liver Transplant
Imaging findings
Serial CT scans following orthotopic liver transplantation show a small left hemidiaphragmatic defect containing fat that slowly enlarged over a year to contain the gastric fundus. A subsequent scan shows acute gastric incarceration, with marked distension and ischemia of the herniated stomach and associated pleural fluid.
Key takeaways
Diaphragmatic injuries can occur during upper abdominal surgery, such as liver transplantation. Small, undetected diaphragmatic lacerations can slowly enlarge over time due to the pressure gradient between the abdomen and chest. They can lead to delayed herniation and life-threatening incarceration or strangulation of the stomach or colon.
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