Surgically treated diaphragmatic perforation after radiofrequency ablation for hepatocellular carcinoma

Figure 1 Child-Pugh score significantly increased between “just after radiofrequency ablation” to at the onset of perforation (P = 0. 031). ^aIndicates values that are statistically significant (P < 0.05). RFA: Radiofrequency ablation.

Figure 2 Tumors treated by radiofrequency ablation. A: Contrast-enhanced computed tomography (CT) shows hepatocellular carcinoma in segment 6 of the liver (Case 4); B: Abdominal CT image at just radiofrequency ablation shows a lesion of ablation (Case 4).

Figure 3 Coronal computed tomography image at onset of diaphragm perforation, showing a right diaphragm hernia. The right colon is deviated into the thoracic cavity through the diaphragm defect (white arrow) (Case 4).

Figure 4 All cases of diaphragm rupture were treated by surgical laparotomy and simple suture of the diaphragm defect. A: A 5 cm defect of diaphragm is visible (black arrow), with evidence of post-ablation scarring (white arrow) (Case 2); B: The defect was repaired with interrupted sutures (Case 2).