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Case Reports
. 2026 Spring;26(1):41-44.
doi: 10.31486/toj.25.0071.

Isolated Herniation of Gallbladder Through Diaphragmatic Defect Following Hepatic Microwave Ablation

Ivan Buitrago  1 , Jordan Spring  1 , William C Conway  1
Affiliations
Case Reports

Isolated Herniation of Gallbladder Through Diaphragmatic Defect Following Hepatic Microwave Ablation

Ivan Buitrago et al. Ochsner J. 2026 Spring.

Abstract

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.

Keywords: Diagnostic imaging; instrumentation; surgery.

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Conflict of interest statement

The authors have no financial or proprietary interest in the subject matter of this article.

Figures

Figure 1.
Figure 1.
Computed tomography sagittal view shows gallbladder diaphragmatic herniation (arrow).
Figure 2.
Figure 2.
Computed tomography coronal view shows gallbladder diaphragmatic herniation with prominent cystic duct (arrow).
Figure 3.
Figure 3.
Intraoperative image shows the gallbladder herniating through the diaphragm (arrow).
Figure 4.
Figure 4.
Intraoperative image shows the primary diaphragmatic defect (arrow) after reduction of the gallbladder.
Figure 5.
Figure 5.
Intraoperative image shows diaphragmatic defects prior to repair (arrows).
Figure 6.
Figure 6.
Intraoperative image shows the diaphragm after primary repair (arrow).
See this image and copyright information in PMC

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