Angiotensin converting enzyme inhibitor associated spontaneous herniation of liver mimicking a pleural mass:A case report  

作　　者：Sameer Saleem Tebha Zain Ali Zaidi Sehrish Sethar Muhammad Asif Abbas Virk Muhammad Nadeem Yousaf 

机构地区：[1]Department of Neurosurgery and Neurology,Jinnah Medical and Dental College,Karachi 75600,Sindh,Pakistan [2]Department of Medicine,Jinnah Medical and Dental College,Karachi 75600,Sindh,Pakistan [3]Department of Radiology,Jinnah Medical and Dental College,Karachi 75600,Sindh,Pakistan [4]Department of Medicine,Division of Gastroenterology,Well Span York Hospital,York,PA 17403,United States [5]Department of Medicine,Division of Gastroenterology and Hepatology,University of Missouri,Columbia,MO 65212,United States

出　　处：《World Journal of Hepatology》2022年第4期854-859,共6页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Spontaneous diaphragmatic herniation of the liver is a rare entity.It may mimic pulmonary mass especially in the absence of trauma.Cough is a common side effect of angiotensin converting enzyme(ACE)inhibitors that may cause diaphragmatic rupture due to a sudden increase in trans-diaphragmatic pressure.We present a case of ACE-inhibitor associated spontaneous herniation of the liver mimicking pleural mass.CASE SUMMARY An 80-year-old woman presented with dry cough for 1 mo and sudden onset of cramping abdominal pain for 1 d.She denied history of trauma,prior surgeries,smoking,alcohol or illicit drug use.She has a history of diabetes and was started on an ACE inhibitor 6 mo ago for the management of hypertension.Examination was remarkable for right upper quadrant tenderness.Lab work-up was unremarkable.Chest X-ray showed a right lower lung opacity suspecting right pleural mass.Chest computed tomography scan ruled out pleural mass,however,revealed herniated right lobe of the liver(3.9 cm×3.6 cm×3.4 cm)into the thoracic cavity through the posterolateral diaphragmatic defect.Laparoscopic repair of the diaphragmatic defect was performed and the ACE inhibitor was stopped.Patients’symptoms had completely resolved on follow-up.CONCLUSION ACE inhibitor-associated cough may cause diaphragmatic liver herniation mimicking pleural mass.Early diagnosis,surgical repair and addressing the triggering factors improve patients’outcomes.

关 键 词：Diaphragmatic hernia Liver herniation ACE-INHIBITORS COUGH Non-traumatic diaphragmatic hernia Case report 

分 类 号：R657.3[医药卫生—外科学]