A 2-week wait referral diagnosed with post-sternotomy liver herniation in a background of adrenal myelolipoma

BMJ Case Rep. 2019 Jul 26;12(7):e230594. doi: 10.1136/bcr-2019-230594.

Abstract

Herniation of the liver through the anterior abdominal wall is a rare post-sternotomy complication. A 32-year-old woman had a 2-week wait referral due to abdominal pain, weight loss and upper abdominal swelling. She was known to have a left adrenal myelolipoma and had a mitral valve replacement 3 years prior to presentation with the postoperative period complicated by sepsis and poor wound healing. She had recently been started on metformin for type 2 diabetes mellitus and she had long-standing lower abdominal symptoms known to the gynaecology team. Investigations revealed hepatic herniation of liver segments II & III through the anterior abdominal wall while there was no underlying malignancy a benign left adrenal myelolipoma was noted.

Keywords: adrenal disorders; cardiothoracic surgery; general surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Adult
  • Colonoscopy
  • Female
  • Hernia, Ventral / diagnostic imaging
  • Hernia, Ventral / pathology*
  • Hernia, Ventral / surgery
  • Humans
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / pathology*
  • Liver Diseases / surgery
  • Myelolipoma / surgery*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / pathology*
  • Postoperative Complications / surgery
  • Referral and Consultation*
  • Sternotomy / adverse effects*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Weight Loss