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Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation
Joint Authors
Jamkhana, Zafar Akram
Cull, Stephanie
Khneizer, Gebran
Krishna, Abhishek
Muzaffar, Razi
Gadani, Sameer
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-03-14
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Acquired diaphragmatic perforation leading to massive hepatic hydrothorax and respiratory failure is a rare complication of microwave ablation (MWA) of hepatocellular carcinoma (HCC).
Imaging modalities to detect pleuroperitoneal communication remain poorly described.
We report a nuclear imaging technique used to efficiently diagnose and locate diaphragmatic defects.
A 57-year-old male with cirrhosis and HCC presented with respiratory distress after undergoing MWA of a HCC lesion.
He was admitted to the intensive care unit for noninvasive positive pressure ventilator support.
Chest radiography revealed a new large right pleural effusion.
Large-volume thoracentesis was consistent with hepatic hydrothorax.
The fluid reaccumulated within 24 hours; therefore an acquired diaphragmatic perforation induced by the ablation procedure was suspected.
To investigate, 99mTechnetium-labeled albumin was injected into the peritoneal cavity.
The tracer accumulated in the right hemi thorax almost immediately.
The patient then underwent transjugular intrahepatic portosystemic shunting in efforts to relieve portal hypertension and decrease ascites volume.
Unfortunately, the patient deteriorated and expired after few days.
Although diaphragmatic defects develop in cirrhotic patients, such small fenestrations do not normally lead to rapid development of life-threatening pleural effusion.
MWA procedures can cause large diaphragmatic defects.
Immediate detection of this complication is essential for initiating early intervention.
American Psychological Association (APA)
Cull, Stephanie& Khneizer, Gebran& Krishna, Abhishek& Muzaffar, Razi& Gadani, Sameer& Jamkhana, Zafar Akram. 2017. Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation. Case Reports in Critical Care،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144408
Modern Language Association (MLA)
Cull, Stephanie…[et al.]. Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation. Case Reports in Critical Care No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1144408
American Medical Association (AMA)
Cull, Stephanie& Khneizer, Gebran& Krishna, Abhishek& Muzaffar, Razi& Gadani, Sameer& Jamkhana, Zafar Akram. Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation. Case Reports in Critical Care. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1144408
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144408