Isolated Herniation of Gallbladder Through Diaphragmatic Defect Following Hepatic Microwave Ablation.

BACKGROUND

Thermal ablation is commonly used to control metastatic hepatic lesions. The documented overall major complication rate is low (4.1%), with a lower incidence of damage to organs (<0.7%). Diaphragmatic injuries resulting from thermal ablation can cause pain and pleural effusions and, rarely, herniation of intra-abdominal contents into the thoracic cavity.

CASE REPORT: We present a case of isolated gallbladder herniation through a diaphragmatic defect after microwave ablation. The patient's complication was corrected surgically with robotic reduction of the herniated gallbladder, closure of the diaphragmatic defect, and cholecystectomy.

CONCLUSION

To our knowledge, diaphragmatic hernia causing herniation of the gallbladder has not been previously reported. Our patient's diaphragmatic defect became symptomatic after a delay of 2 years. Such a delay is common, and practitioners should be aware of delayed symptoms after ablation as early detection can improve patient outcomes.