A 2-week wait referral diagnosed with post-sternotomy liver herniation in a background of adrenal myelolipoma.
Bankole K OyewoleMohamed BoshnaqMohammed YaktienShabbir AhmedPublished in: BMJ case reports (2019)
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.
Keyphrases
- mitral valve
- weight loss
- abdominal pain
- primary care
- wound healing
- bariatric surgery
- patients undergoing
- intensive care unit
- palliative care
- acute kidney injury
- randomized controlled trial
- heart failure
- single cell
- glycemic control
- type diabetes
- left ventricular
- clinical trial
- left atrial
- adipose tissue
- sleep quality
- study protocol
- quality improvement
- cardiovascular risk factors
- septic shock
- insulin resistance
- aortic valve
- body mass index