Thoracic complications of radiofrequency ablation of recurrent hepatoma

ABSTRACT

<p><b>INTRODUCTION</b>Radiofrequency ablation (RFA) for unresectable primary or secondary hepatic malignancies have gained widespread availability and acceptance over the past 5 years. Complication rates have been reported to range from 0% to 27%.</p><p><b>CLINICAL PICTURE</b>We report a patient with symptomatic right pleural effusion due to a diaphragmatic fistula and another with biliptysis post-RFA, for recurrent hepatoma.</p><p><b>TREATMENT</b>Percutaneous drainage of both the pleural effusion and biloma was performed. However, surgical repair of the diaphragmatic fistula was only required for the former for persistent drainage.</p><p><b>OUTCOME</b>Both patients were successfully treated with minimal morbidity.</p><p><b>CONCLUSION</b>High index of suspicion is required for the early diagnosis and treatment of diaphragmatic fistulas. Simple catheter drainage can potentially obviate the need for surgery.</p>