Skip to main content

Right-sided diaphragmatic hernia in an adult after living donor liver transplant: a rare cause of post-transplant recurrent abdominal pain

Abstract

Right-sided diaphragmatic hernia (DH) after living donor liver transplant in adult recipients has not been described previously. There have been a few reports of right-side DH in paediatric living donor liver transplant recipients and following right lobe donor hepatectomy. We herein describe the first instance of right-sided DH in a 44-year-old man who underwent left lobe live donor liver transplant. Twenty-eight months later, he presented with recurrent right upper abdominal pain. Radiographic workup revealed a right-sided DH. He underwent laparotomy and primary repair of the diaphragmatic defect. Seven months after the repair, the patient remains well and free from symptoms, with a normal chest X-ray. Right-sided DH is rare but may occur after living donor liver transplant. Successful outcome can be achieved by an early diagnosis and prompt management.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Johnson CD, Ellis H (1988) Acquired hernias of the diaphragm. Postgrad Med J 64:317–321

    CAS  Article  PubMed  Google Scholar 

  2. Visset J, Le Neel JC, Duveau D et al (1983) Ruptures traumatiques du diaphragme. Presse Med 12:1211–1214

    CAS  PubMed  Google Scholar 

  3. Johnson CD, Shandall A (1987) Incisional hernia of the diaphragm causing large bowel obstruction. J R Coll Surg Edinb 32:51–52

    CAS  PubMed  Google Scholar 

  4. Wood TF, Rose DM, Chung M et al (2000) Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications. Ann Surg Oncol 7:593–600

    CAS  PubMed  Google Scholar 

  5. McCabe AJ, Orr JD, Sharif K et al (2005) Right-sided diaphragmatic hernia in infants after liver transplantation. J Pediatr Surg 40:1181–1184

    Article  PubMed  Google Scholar 

  6. Englert C, Helmke K, Richter A et al (2006) Diaphragmatic hernia resulting in enterothorax following pediatric liver transplantation: a rare complication. Transplantation 82:574–576

    Article  PubMed  Google Scholar 

  7. Bonatti H, Muiesan P, Connelly S et al (1997) Hepatic transplantation in children under 3 months of age: a single centre’s experience. J Pediatr Surg 32:486–488

    CAS  Article  PubMed  Google Scholar 

  8. Hawxby AM, Mason DP, Klein AS (2006) Diaphragmatic hernia after right donor and hepatectomy: a rare donor complication of partial hepatectomy for transplantation. Hepatobiliary Pancreat Dis Int 5:459–461

    PubMed  Google Scholar 

  9. Blachar A, Federle MP (2001) Bowel obstruction following liver transplantation: clinical and CT findings in 48 cases with emphasis on internal hernia. Radiology 218:384–388

    CAS  PubMed  Google Scholar 

  10. Kapoor BS, Hunter DW (2003) Injection of subphrenic saline during radiofrequency ablation to minimize diaphragmatic injury. Cardiovasc Intervent Radiol 26:302–304

    Article  PubMed  Google Scholar 

  11. Koda M, Ueki M, Maeda N et al (2003) Diaphragmatic perforation and hernia after hepatic radiofrequency ablation. Am J Roentgenol 180:1561–1562

    Google Scholar 

  12. Rubikas R (2001) Diaphragmatic injuries. Eur J Cardiothorac Surg 20:53–57

    CAS  Article  PubMed  Google Scholar 

  13. Martinez M, Briz JE, Carillo EH (2001) Video thoracoscopy expedites the diagnosis and treatment of penetrating diaphragmatic injuries. Surg Endosc 15:28–32

    CAS  Article  PubMed  Google Scholar 

  14. Reber PU, Schmied B, Seiler CA et al (1998) Missed diaphragmatic injuries and their long-term sequelae. J Trauma 44:183–188

    CAS  Article  PubMed  Google Scholar 

  15. Willemse P, Schütte PR, Plaisier PW (2003) Thoracoscopic repair of a Bochdalek hernia in an adult. Surg Endosc 17:162

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Perwaiz.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Perwaiz, A., Mehta, N., Mohanka, R. et al. Right-sided diaphragmatic hernia in an adult after living donor liver transplant: a rare cause of post-transplant recurrent abdominal pain. Hernia 14, 547–549 (2010). https://doi.org/10.1007/s10029-009-0594-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-009-0594-y

Keywords

  • Right-sided diaphragmatic hernia
  • Acquired diaphragmatic hernia
  • Postoperative diaphragmatic hernia
  • Liver transplantation