胸膜腫瘍が疑われた横隔膜欠損孔からの肝ヘルニアの1例

Liver Herniation through a Diaphragmatic Defect Mimicking Pleural Tumor；Report of a Case

はじめに　肝ヘルニアは，肝臓が横隔膜の欠損部から胸腔内へ逸脱する病態である．外傷や手術歴のない成人における肝ヘルニアはまれで，肺腫瘍や横隔膜腫瘍と診断され手術となる症例がしばしば報告されている．われわれは，術前に胸膜腫瘍と診断した肝ヘルニアの1例を経験したので報告する．

Liver herniation is rare and sometimes difficult to differentiate from pleural or diaphragmatic tumor. A 64-year-old woman was admitted due to a mass-like shadow in the right lower lung field. Computed tomography, coronal view, showed a well-defined mass forming an acute angle with the right diaphragm, mimicking pleural tumor. Video-assisted thoracic surgery was performed, revealing herniated liver through one of the multiple diaphragmatic defects, which was repositioned into the abdominal cavity, and the diaphragmatic defect was repaired. The patient recovered well and was discharged on postoperative day 5.