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Journal of the Korean Liver Cancer Study 2011;11(2):172-177.
Published online September 30, 2011.
A Case of Intractable Duodenal Ulcer Bleeding Followed by Hepatic Abscess after Transarterial Chemoembolization on Recurrent Hepatocellular Carcinoma
Keun Soo Ahn, Koo Jeong Kang, Young Hoon Kim, Tae Jin Lim
Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
Correspondence:  Koo Jeong Kang,
Email: kjkang@kmu.ac.kr
Copyright ©2011 by The Korean Liver Cancer Association
Abstract
Transarterial chemoembolization (TACE) is widely used in patients with hepatocellular carcinoma (HCC). Although this procedure is being performed safely and effectively, severe complications including liver abscess, upper gastrointestinal bleeding and liver failure can be rarely occurred. A 63-year-old female patient was admitted due to hematochezia for 1 day. She underwent central bisectionectomy for HCC 3 months ago. On follow up computed tomography, large recurred HCC was found at left lateral section and she underwent TACE. Ten days after TACE, she complained anorexia, general weakness and hematochezia and admitted. On gastroduodenoscopy, diffuse and shallow ulcer with bleeding was noted at duodenal bulb and it was controlled by epinephrine injection. However, recurrent ulcer bleeding was occurred and she underwent a dozen times of endoscopic intervention and one time of angiographic intervention to control bleeding. Although ulcer bleeding was stopped, it was followed by liver abscess in the left lateral section. The abscess was drained by pig-tail catheter, however the patient resulted in dead by hepatic failure. It is hard to manage the severe complications after TACE, therefore TACE should be applied judiciously including super selection of hepatic artery and early detection of complications and appropriate management is necessary.
Key Words: Hepatocellular carcinoma; Chemoembolization; Ulcer; Liver abscess
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