The embryological changes involve abnormal migration of myoblasts from the upper cervical somites to the transverse septum (4 weeks of gestation) and pleuroperitoneal
membrane (8 to 12 weeks); microscopy shows diffused fibroelastic changes and lack of fibers.
Even though multiple imaging modalities have been reported for indirect measurement of pleuroperitoneal
communication across the diaphragm, such imaging techniques remain uncommon and not well reported.
It is a serious and rare complication that usually causes the abandonment of techniques while the realization of chemical pleurodesis with sclerosing agents (talc, tetracyclines, blood) can be an effective treatment to solve the pleuroperitoneal
Other cause of technique failure included peritonitis (21.4%), inadequate dialysis (14.3%), catheter-related causes (10.8%), and pleuroperitoneal
communication or subjective factors (21.4%).
Several theories have been proposed to explain the development of ectopic liver at different sites: development of an accessory lobe of the liver with atrophy or regression of the original connection to the main liver, (4) migration or displacement of a portion of the cranial part (Pars hepatica) of the liver bud to other sites, (6) dorsal budding of hepatic tissue before the closing of the pleuroperitoneal
canal (may explain how EL develops in the thoracic cavity such as esophagus, pericardium, intra pleural or extra pleural), (7) trapping of hepatocyte-destined mesenchyma in different areas (8) and entrapment of nests of cells in the region of the foregut following closure of the diaphragm or umbilical ring.
Over grade 3, if severe shortness of breath is present, usually therapeutic thoracentesis, catheter thoracostomy, and pleuroperitoneal
shunt may be required .
It mainly develops from the four components; septum transversum, pleuroperitoneal
membranes, dorsal mesentery of the esophagus and muscular ingrowth from the lateral body walls.
[1,3] The reasons postulated for these observations are the earlier closure of the pleuroperitoneal
canal on the right side than on the left, and the protective effect of the liver on the right diaphragm.
It is more common on the left side as the right pleuroperitoneal
canal closes earlier than the left (4).
Konjenital ya da travma sonucu veya pleuroperitoneal
zarin gelisimsel bozuklugu sonucu olusan diyafram hernileri ile iliskili olabilir.