Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report

Autor: Natascha Roehlen, Richard F. Knoop, Katharina Laubner, Jochen Seufert, Henning Schwacha, Robert Thimme, Andreas Fischer
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Case Reports in Gastroenterology, Vol 12, Iss 2, Pp 352-359 (2018)
Druh dokumentu: article
ISSN: 1662-0631
DOI: 10.1159/000490604
Popis: Drug-eluting bead transarterial chemoembolization (DEB-TACE) is a well-established, minimally invasive interventional treatment for nonresectable hepatocellular carcinoma (HCC). Generally, TACE is regarded as safe and effective with a low complication rate. However, remote gastrointestinal ischemia due to the carryover of embolic material into visceral arteries is a rare but serious complication of TACE. In this report, we present a case of duodenal ulceration with contained perforation and severe necrotizing pancreatitis after TACE in a patient with nonresectable HCC and underlying hepatitis C virus associated with Child-Pugh stage B liver cirrhosis. This patient showed, for the first time, complete endoscopic and clinical recovery within 2 months of conservative treatment. Considering the high mortality rate from surgical intervention in all previously reported patients, the significant recovery potential demonstrated by our case suggests conservative treatment with antibiotics and parenteral nutrition combined with close clinical, radiological, and endoscopic monitoring should be considered in all clinically stable patients without signs of peritonism or septic sequelae.
Databáze: Directory of Open Access Journals