# A Rare Case of a Large Diaphragmatic Hernia With Upward Hepatic Transposition

## TL;DR

This paper describes a rare case of a large diaphragmatic hernia causing the liver to herniate into the thoracic cavity during a cadaveric dissection.

## Contribution

The study presents a unique anatomical case of a congenital diaphragmatic defect with extensive thoracoabdominal reorganization.

## Key findings

- A 13 cm defect in the right diaphragmatic dome allowed the right hepatic lobe to herniate into the thoracic cavity.
- The herniation caused mediastinal shift, lung compression, and displacement of abdominal organs like the spleen and colon.
- The case underscores the diagnostic challenges of intrathoracic liver hernias mimicking thoracic masses.

## Abstract

This study reports a rare case of an intrathoracic hepatic hernia identified during cadaveric dissection, characterized by a large congenital hiatus in the right diaphragmatic dome that permitted the herniation of the right hepatic lobe and displacement of adjacent abdominal viscera. The case was observed in the cadaver of an adult male, approximately 50 years old. During anatomical dissection, a defect measuring about 13 cm in the right dome of the diaphragm was found, resulting in the migration of the entire right hepatic lobe into the thoracic cavity, compression of the right lung, mediastinal shift, and displacement of other viscera, including splenic ectopia and migration of the hepatic flexure and transverse colon. The anatomical findings were documented photographically, measured, and analyzed in light of the existing literature. Intrathoracic liver hernias pose diagnostic challenges because they may mimic mediastinal or pulmonary masses. This case highlights the extensive thoracoabdominal reorganization that can result from congenital diaphragmatic defects and emphasizes the importance of thorough anatomical and imaging evaluations to ensure accurate diagnosis and to guide clinical and surgical management.