Clin Mol Hepatol.  2012 Sep;18(3):321-325. 10.3350/cmh.2012.18.3.321.

A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma

• Bae SI
• Yeon JE
• Lee JM
• Kim JH
• Lee HJ
• Lee SJ
• Suh SJ
• Yoon EL
• Kim HR
• Byun KS
• Seo TS

• KMID: 1392913
• DOI: http://doi.org/10.3350/cmh.2012.18.3.321

Abstract

Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.

Keyword

Carcinoma, Hepatocellular; Therapeutic chemoembolization; Acute necrotizing pancreatitis

MeSH Terms

Abscess/microbiology
Aged
Anti-Bacterial Agents/therapeutic use
Carcinoma, Hepatocellular/*complications/*therapy
Chemoembolization, Therapeutic/*adverse effects
Cholangiopancreatography, Endoscopic Retrograde
Citrobacter freundii/isolation & purification
Drainage
Drug Resistance, Multiple, Bacterial
Enterobacteriaceae Infections/drug therapy
Hepatitis B/complications
Humans
Klebsiella/isolation & purification
Klebsiella Infections/drug therapy
Liver Cirrhosis/etiology
Liver Neoplasms/*complications/*therapy
Male
Necrosis/*diagnosis/etiology
Pancreatitis/*diagnosis/etiology
Tomography, X-Ray Computed