Massive diaphragmatic herniation following orthotopic liver transplantation in an adult

✍ Scribed by Doris Wagner; Florian Iberer; Michael Sereinigg; Daniela Kniepeiss; Peter Kornprat; Astrid Fahrleitner-Pammer; Philipp Stiegler; Karlheinz Tscheliessnigg

• Book ID: 102933636
• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 632 KB
• Volume: 16
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22079

✦ Synopsis

Congenital diaphragmatic hernias are relatively common. 1 However, they are rarely associated with displacement of abdominal organs into the thorax. 2 Diaphragmatic hernias following surgery occur most commonly after thoraco-abdominal trauma; the incidence of such hernias is 0.8% to 5%. 3 Up to 30% of these hernias have a late presentation; they often present several days after blunt trauma. 4,5 The nonspecific nature of the symptoms associated with these hernias, which may not suggest the correct diagnosis, 6 may explain why, for a large proportion of patients with these lesions, either the diagnosis is made only after a long interval or it remains unmade. 7,8 Diaphragmatic herniation with enterothorax has not been reported after orthotopic liver transplantation in adults, but it has been reported to occur rarely after pediatric liver transplantation 9 or after partial liver transplantation. The clinical features exhibited by patients that develop this complication tend to be misleading and often suggest infections or allograft rejection.