A rare case of left diaphragmatic palsy with beaver tail anomaly of liver mimicking pericardial hematoma

Abstract

We report a post CABG patient who presented two weeks postprocedure for transthoracic echocardiography. He had postoperative left diaphragmatic paralysis, under conservative management. His TTE images revealed suspicious structure compressing the LV similar to an organized hematoma. Emergency Cardiac CT scan revealed the absence of pericardial hematoma but showed a sliver of left lobe of liver lying adjacent to the posterior wall of LV. The patient had a rare anatomic variation called the beaver tail liver which was now lying in the thorax due to the diaphragmatic palsy. To the best of our knowledge, such a mimicker of pericardial hematoma has previously not been reported in literature.

Keywords

• Post CABG
• Left diapragmatic paralysis
• Beaver tail liver
• Transthoracic echocardiography