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JLC : Journal of Liver Cancer

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10 "Complication"
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Case Reports
Two Cases of Spontaneous Bacterial Peritonitis Developed Right after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Jung Hoon Lee, Joo Hyun Sohn, Tae Yeob Kim, Ji Young Lee, Ki Sul Chang, Dong Hoon Lee, Eun Sik Park
Journal of the Korean Liver Cancer Study Group. 2013;13(2):145-151.   Published online September 30, 2013
DOI: https://doi.org/10.17998/jlc.13.2.145
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AbstractAbstract PDF
Although acute hepatic failure (AHF) after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is not a rare complication, the development of spontaneous bacterial peritonitis (SBP) is uncommon. We describe two cases who suffered SBP and AHF right after TACE for HCCs. In the first case, 5 days after TACE ascites and jaundice newly developed and SBP was diagnosed at 9 days after TACE. After use of secondary antibiotics (imipenam) due to failure of primary therapy with 3rd cephalosporin, he discharged with resolution of SBP. In the second case, jaundice, abdominal pain and fever developed with increased ascites 3 days after TACE. After 8 days, SBP was diagnosed and treated with imipenam due to primary treatment failure, but clinical course was deteriorated. Eighteen days after discharge, she died of AHF. In patients with increased ascites and fever after TACE, clinician should be considered SBP with AHF among post-TACE complications, and prompt management is needed.
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A Case of Necrotizing Pancreatitis after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Mi Na Kim, Jung Hyun Cho, Young Eun Chon, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon
Journal of the Korean Liver Cancer Study Group. 2012;12(2):155-159.   Published online September 30, 2012
  • 619 Views
  • 2 Downloads
AbstractAbstract PDF
Acute pancreatitis is a rare but severe postprocedural complication after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma with an incidence of 1.7-4%. The proposed mechanism of this complication is inadvertent embolization through collateral vessels or regurgitation of chemotherapeutic agents to the arteries of other organs. Here, we present a fatal necrotizing pancreatitis case which developed 10 days after TACE, caused by the regurgitation of the chemotherapeutic agents to the pancreas during the procedure. The patient recovered with conservative care at first, but after suffering from several times of recurrent pancreatitis, he died of peritoneal septic shock 5 months after the initial pancreatitis attack.
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Review Article
Complications Associated with Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma
Sun Hong Yoo, Si Hyun Bae
Journal of the Korean Liver Cancer Study Group. 2011;11(2):144-148.   Published online September 30, 2011
  • 644 Views
  • 40 Downloads
AbstractAbstract PDF
Transcatheter arterial chemoembolization (TACE) is one of the most effective treatments for patients with inoperable hepatocellular carcinoma (HCC). However, variable complications can occur after TACE. Complications resulting from TACE contain postembolization syndrome, liver abscess, bile duct injury, ruptured HCC, acute hepatic failure, variceal bleeding, acute kidney injury, pulmonary lipiodol embolization, femoral artery pseudoaneurysm, femoral arteriovenous fistula, abdominal aortic dissection, spinal cord injury, and others. Complications after TACE are occasionally fatal. Therefore, it is important that we are well acquainted ourselves with these complications, and need care promptly the patient who develop symptoms of complication.
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Case Reports
A Case of Hepatocellular Carcinoma Recurred Extensively during Treatment of Biliary Complication Occurring after Transarterial Chemoembolization
Hyun Jung Oh, Hana Park, Kwang Hoon Lee, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park
Journal of the Korean Liver Cancer Study Group. 2011;11(2):178-184.   Published online September 30, 2011
  • 537 Views
  • 3 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma(HCC) is one of the cancers with poor prognosis. Transarterial chemoembolization(TACE) has been widely used for treating unresectable HCC. Although TACE is considered as a less invasive and relative safe procedure, severe complications such as hepatic failure, pulmonary embolism, liver abscess, biloma formationcan occur rarely after TACE. These complications sometimes may lead to fatal clinical situation, even death. We reported a case of HCC recurred extensively during treatment of biliary complication after TACE. A 44-year-old male with HCC was admitted due to fever for 3 days after undergoing TACE. Three weeks before the admission, he had been diagnosed with HCC recurrence which presented as two arterial enhancing nodules in MRI and treated with TACE. CT scan showed 7 cm sized air containing fluid collections with necrosis suggestive of liver abscess and 15 cm sized biloma formation. Because the patient was in septic shock at admission, percutaneous catheter drainage was performed with use of broad spectrum antibiotics. After treatment of 3 months, the sizes of hepatic abscess and biloma were remarkably decreased. However, 1 month later, large size tumor recurrence and perihepatic lymph node metastasis were found on a follow-up CT scan. In this case, the cause of rapid growing recurrence after TACE is uncertain, but the development of unanticipated complication seems to affect the progression to poor prognosis. Therefore, early recognization of predisposing factors with proper management would be needed to prevent these serious complications after TACE.
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A Case of Mechanical Obstruction after Radiofrequency Ablation of Hepatocellular Carcinoma
Ji Eun Lee, Jae Young Jang, Soung Won Jeong, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
Journal of the Korean Liver Cancer Study Group. 2011;11(2):195-198.   Published online September 30, 2011
  • 624 Views
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AbstractAbstract PDF
Radiofrequency ablation (RFA) inducing of coagulation necrosis by using thermal energy via electrodes placed within the tissue effectively controls hepatocellular carcinoma (HCC). RFA has been commonly applied as an alternative curative therapy to surgical resection for small HCC due to effective local tumor control. Although the technique is considered relatively safe, several major complications requiring hospitalization for treatment have been reported such as vascular thrombosis, pneumothorax, pleural effusion, skin burn, hematoma, liver abscess and colon perforation. Most complications occur due to thermal injuries to adjacent structures by RFA. The risk of bowel perforation has been observed only when the target lesion is adjacent to a gastrointestinal lumen, but, mechanical obstruction is extremely rare. Therefore, we report a case of mechanical obstruction after transaction of ileum secondary to RFA of HCC.
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Review Article
Complications after Radiofrequency Thermal Ablation of Hepatocellular Carcinoma
Hyunchul Rhim
Journal of the Korean Liver Cancer Study Group. 2005;5(1):12-17.   Published online June 30, 2005
  • 554 Views
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AbstractAbstract PDF
Radiofrequency (RF) thermal ablation has been accepted as a promising technique for treating unresectable liver tumors. However, any interventional procedure should only be performed with minimal morbidity and mortality. Recently three separate multicenter surveys have shown an acceptable morbidity and mortality for a minimally invasive technique. The mortality ranged from 0.1-0.5%, the major complication rate from 2.2-3.1% and minor complication rate from 5-8.9%. The most common causes of death were sepsis and hepatic failure, and the most common major complications were intra-peritoneal bleeding, hepatic abscess, bile duct injury, hepatic decompensation and grounding pad burns. Minor complications and side effects were more common than major complications, but most of them were transient and self-limiting. The operator must understand the broad spectrum of complications after RF ablation as well as the strategies to minimize and manage appropriately
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Case Reports
A Case of Intraperitoneal Hemorrhage after Radiofrequency Ablation
Yeon Seok Seo, Soon-Ho Um, Yun Hwan Kim
Journal of the Korean Liver Cancer Study Group. 2005;5(1):60-67.   Published online June 30, 2005
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AbstractAbstract PDF
A case of intraperitoneal hemorrhage after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) was presented. Fifty-six years old male was admitted in our hospital to evaluate two hepatic masses found on ultrasonographic screening examination. With 3-phase abdominal CT, the masses were diagnosed as HCC. For the treatment, TACE was performed, but therapeutic response was inadequate, so RFA was performed. On 2nd day after RFA, he complained dizziness with hemoglobin level being lowered. Abdominal distension was aggravated, and on diagnostic paracentesis, the bloody ascites were noted. Urgent celiac angiogram was performed, but any definite bleeding focus was not found. With conservative management, his condition improved without a further decrease in following hemoglobin level. He was discharged on 20th day after RFA.
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A Case of Needle Tract Implantation of Hepatocellular Carcinoma after Radiofrequency Ablation
Nak So Chung, Cheul Hee Park, So Young Kwon, Young Nam Kim, Oh Sang Kwon, Sun Suk Kim, Duck Joo Choi, Ju Hyun Kim
Journal of the Korean Liver Cancer Study Group. 2005;5(1):68-70.   Published online June 30, 2005
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AbstractAbstract PDF
The tumor seeding after local ablation therapy is a rare complication in hepatocellular carcinoma. We report a
case
of needle tract implantation of hepatocellular carcinoma following radiofrequency ablation therapy manifested as a omental mass. The metastatic mass was surgically removed.
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Surgical Removal of Needle-Tract Seeding in Hepatocellular Carcinoma: A Report of Two Cases
Soo Ah Kim, Won Jae Lee, Seung Hoon Kim, Hyo Keun Lim
Journal of the Korean Liver Cancer Study Group. 2002;2(1):69-72.   Published online July 31, 2002
  • 606 Views
  • 2 Downloads
AbstractAbstract PDF
We describe two case of needle-tract seeding found in the abdominal wall after performing needle biopsy and radiofrequency ablation in a 56 year-old man and 41-year-old woman with hepatocellular carcinomas. Needle-tract seeding was identified at CT 19 and 14 months after the interventional procedures, respectively. Surgical removal was undergone successfully in both patients
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An Ischemic Skin Lesion after Chemoembolization of the Right Internal Mammary Artery in a Patient with Hepatocellular Carcinoma
Jae-Hoon Lee, Chae Yoon Chon, Yong-Han Paik, Kwang-Hyub Han, Jong Tae Lee, Do Yun Lee, Young Myoung Moon
Journal of the Korean Liver Cancer Study Group. 2001;1(1):133-136.   Published online June 30, 2001
  • 499 Views
  • 4 Downloads
AbstractAbstract PDF
A large nodular hepatocellular carcinoma located at the anterior superior portion of the left lobe was treated with transcatheter arterial chemoembolization through the left hepatic artery. Three months later, however, there was a re-elevation of the serum alpha-fetoprotein level and an evidence of a marginal recurrence at the left side of the previously embolized tumor was noted on the postembolizeation computed tomographic scan. Although the hepatic artery was intact in the second hepatic arteriography, we found that the right internal mammary artery was feeding the recurred hepatocellular carcinoma. Right internal mammary artery was successfully treated with Lipiodol-transcatheter arterial chemoembolization. However, an ischemic lesion occurred in the skin of the anterior chest and abdominal wall several days after the embolization of the internal mammary artery. We report here a very rare case of ischemic skin lesion on the anterior chest and abdominal wall following transcatheter arterial chemoembolization of the right internal mammary artery. This internal mammary artery was embolized because it had developed a collateral tumor feeding vessel following the initial chemoembolization of a hepatocellular carcinoma.
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JLC : Journal of Liver Cancer