Diaphragmatic necrosis after radiofrequency ablation of hepatocellular carcinoma: A successful surgical repair - 16/04/13
Corresponding author. Université Paris 13, Sorbonne Paris Cité, 93206 Saint-Denis, France; AP–HP, Pôle de Spécialités Cancérologiques, Service de Chirurgie Thoracique et Vasculaire, Hôpital Avicenne, 125, route de Stalingrad, 93009 Bobigny, France; Laboratoire de Recherches Bio-chirurgicales, Université Paris Descartes, 75015 Paris, France. Tel.: +33 1 48 95 58 31; fax: +33 1 48 95 52 32.Summary |
We report a case of complete hemidiaphragmatic necrosis with liver abscess complicating radiofrequency ablation of a large subdiaphragmatic hepatocellular carcinoma in a patient with unrecognized history of endoscopic oddi sphincterotomy. At 2-year follow-up after surgical repair using a pedicled latissimus dorsi flap, clinical examination and imaging did not show complication or cancer recurrence. The risk of complete hemidiaphragmatic necrosis resulting from both thermal and septic injuries should be considered when radiofrequency ablation is performed for liver dome tumors, particularly in patients with impaired oddi sphincter. In this septic situation, a latissimus dorsi flap appears as the unique opportunity to repair the injured hemidiaphragm.
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Vol 37 - N° 2
P. e59-e63 - avril 2013 Retour au numéro
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