A Rare Complication of Diaphragm Plication: Acute Liver Injury From Hepatic Compartment Syndrome

Michael Chang; Samantha Menegas; David Uihwan Lee; Muhammad Baraa Hammami; Sasan Sakiani

doi:10.14309/crj.0000000000001127

A Rare Complication of Diaphragm Plication: Acute Liver Injury From Hepatic Compartment Syndrome

ACG Case Rep J. 2023 Aug 30;10(9):e01127. doi: 10.14309/crj.0000000000001127. eCollection 2023 Sep.

Authors

Michael Chang¹, Samantha Menegas¹, David Uihwan Lee², Muhammad Baraa Hammami², Sasan Sakiani²

Affiliations

¹ University of Maryland School of Medicine, Baltimore, MD.
² Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.

Abstract

Diaphragm plication is a surgical treatment of unilateral diaphragm paralysis, in which the affected diaphragm is sutured in place. Because the right diaphragm sits on top of the liver, right-sided diaphragm plication can injure the liver and lead to hepatic compartment syndrome resulting in acute liver injury. We report a case of a 59-year-old woman with a history of multilevel disk degeneration and alcohol use disorder who underwent right-sided diaphragm plication. After surgery, she complained of abdominal pain and was found to have severely elevated liver-associated enzymes and evidence of acute liver injury, which resolved with supportive care.

Keywords: acute liver injury; diaphragm plication; hepatic compartment syndrome; liver; surgery.

Publication types

Case Reports