CTICasesIatrogenic Diaphragmatic Hernia
Imaging findings
CTA of the abdomen in a patient with a history of hepatocellular carcinoma post-local ablation therapy (RFA/cryoablation) demonstrates a localized diaphragmatic defect in the posterior right dome, with a portion of the liver (segments 7/8) herniating superiorly into the right hemithorax, forming a mushroom-like contour on sagittal reconstructions. This was repaired using a synthetic patch.
Key takeaways
Diaphragmatic hernia is a recognized, late complication of local thermal ablation therapies (such as radiofrequency ablation or cryoablation) for hepatic tumors located at the dome of the liver. The thermal energy can damage and necrosis the adjacent diaphragm, leading to a delayed tear and herniation of the liver, which requires surgical patch closure to prevent strangulation or respiratory compromise.
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