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


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.

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  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 

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Correspondence to A. Perwaiz.

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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).

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