Asian J Endosc Surg

. 2022 Apr 20. doi: 10.1111/ases.13067. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/35445564/

Liver herniation mimicking a thoracic tumor with restoration of the liver surface structure on closure of the hernia orifice under thoracoscopic surgery

Takeshi Ikeda ¹, Ryusuke Sumiya ¹, Aya Sugimura ¹, Hoshie Hirai ¹, Satoshi Nagasaka ¹Affiliations expand

• PMID: 35445564
• DOI: 10.1111/ases.13067

Abstract

Non-congenital, non-traumatic spontaneous diaphragmatic liver hernia in adults is extremely rare and sometimes misdiagnosed as a thoracic tumor. Almost all previous reports with a definitive diagnosis reported preservation; thus, differential diagnosis is extremely important for planning optimal management of such clinical conditions. An abnormal shadow in the right lower lung field was detected on chest radiography in a 61-year-old woman. Further imaging study revealed a 33-mm diameter mass adjacent to the right diaphragm. Thoracoscopic surgery was performed as diagnostic treatment. We found a pale hemispherical herniated liver on the central tendon of the diaphragm. After repositioning the herniated liver, the orifice was closed with a non-absorbable suture, and the surface of the liver returned to being a perfectly smooth surface. With this result, we believe that repair of diaphragmatic liver hernia through a minimally invasive procedure has great benefits for patients.

Keywords: liver herniation; thoracic tumor; thoracoscopic surgery.

© 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.