Post-pleuropneumonectomy herniation of liver mimicking major pulmonary embolism

Asian Cardiovascular and Thoracic Annals.
2006 Jun;14(3):e60-2.

Hanno Huwer, MD, Johannes Winning, MD1, Helmut Isringhaus, MD, Gerhard Kalweit, MD

Department of Cardiothoracic Surgery, Völklingen Heart Centre, Völklingen, Germany
1 Department of Anesthesiology and Critical Care Medicine, University of the Saarland, Homburg, Germany

For reprint information contact: Hanno Huwer, MD Tel: 49 68 9812 2424 Fax: 49 68 9812 2258 Email:
, Department of Cardiothoracic Surgery, Völklingen Heart Centre, D-66333 Völklingen/Saar, Germany.


Following right-sided pneumonectomy and hemidiaphragm resection in a 58-year-old man with epithelioid mesothelioma, acute respiratory insufficiency and life-threatening circulatory collapse developed after a forced Valsalva maneuver. Major pulmonary embolism was diagnosed on clinical grounds, however computed tomography revealed herniation of the liver into the right hemithorax.