CTICasesPost-Operative Diaphragmatic Hernia (after liver transplant)
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Imaging findings
Initial radiographs showed a diaphragmatic eventration that progressively changed over time to a more focal bump and then a clear change in diaphragmatic contour. Subsequent CT demonstrated an abnormal contour to the transplanted liver, which appeared heterogeneous. A diaphragmatic defect was seen, with herniation of liver parenchyma into the extra-pleural space, with the liver not enclosed in a peritoneal hernia sac.
Key takeaways
This case illustrates a post-operative diaphragmatic hernia, likely an unrecognized iatrogenic injury during a liver transplant that manifested years later as progressive thinning of the diaphragm muscle and subsequent herniation. This type of hernia is important to recognize, especially as the liver may not be enclosed in a peritoneal sac.
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