Post-esophagectomy diaphragmatic hernia—a case series

Amreen, Saika; Qayoom, Zahid; Nazir, Nidha; Shaheen, Feroze; Gojwari, Tariq

doi:10.1007/s10353-019-0606-9

Cited by 1 publication

(1 citation statement)

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“…A congenital defect in the diaphragm is the most common cause of diaphragmatic hernia with a reported incidence of 0.8-5 per 10000 births[ 1 ]. Acquired rupture of the diaphragm is most commonly caused by high-velocity blunt or penetration abdomino-thoracic trauma and postsurgical diaphragmatic defect that may result in herniation of abdominal contents into the thoracic cavity[ 2 , 3 ]. Spontaneous diaphragmatic herniation is an uncommon subtype of acquired hernia without history of trauma.…”

Section: Introductionmentioning

confidence: 99%

Angiotensin converting enzyme inhibitor associated spontaneous herniation of liver mimicking a pleural mass: A case report

Tebha¹,

Zaidi²,

Sethar³

et al. 2022

WJH

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BACKGROUND Spontaneous diaphragmatic herniation of the liver is a rare entity. It may mimic pulmonary mass especially in the absence of trauma. Cough is a common side effect of angiotensin converting enzyme (ACE) inhibitors that may cause diaphragmatic rupture due to a sudden increase in trans-diaphragmatic pressure. We present a case of ACE-inhibitor associated spontaneous herniation of the liver mimicking pleural mass. CASE SUMMARY An 80-year-old woman presented with dry cough for 1 mo and sudden onset of cramping abdominal pain for 1 d. She denied history of trauma, prior surgeries, smoking, alcohol or illicit drug use. She has a history of diabetes and was started on an ACE inhibitor 6 mo ago for the management of hypertension. Examination was remarkable for right upper quadrant tenderness. Lab work-up was unremarkable. Chest X-ray showed a right lower lung opacity suspecting right pleural mass. Chest computed tomography scan ruled out pleural mass, however, revealed herniated right lobe of the liver (3.9 cm × 3.6 cm × 3.4 cm) into the thoracic cavity through the posterolateral diaphragmatic defect. Laparoscopic repair of the diaphragmatic defect was performed and the ACE inhibitor was stopped. Patients’ symptoms had completely resolved on follow-up. CONCLUSION ACE inhibitor-associated cough may cause diaphragmatic liver herniation mimicking pleural mass. Early diagnosis, surgical repair and addressing the triggering factors improve patients’ outcomes.

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Section: Introductionmentioning

confidence: 99%