Tuberc Respir Dis.  2011 Jul;71(1):50-54.

Pulmonary Lipiodol Embolism after Transcatheter Chemoembolization for Hepatocellular Carcinoma

• Park WR
• Kim JT
• Han HS
• Kim SJ
• Choe KH
• Lee KM
• An JY

Abstract

Pulmonary lipiodol embolism is a rare but very fatal complication of transcatheter arterial chemoembolization (TACE), Here we present the case of an unusual complication of TACE in a 67-year-old man who presented with dyspnea, hemoptysis, and a history of a third session of TACE for hepatocellular carcinoma (HCC) that had been performed 3 days prior to presenting. On the basis of chest X-ray and computed tomography (CT) scan findings, we diagnosed pulmonary lipiodol embolism. He was conservatively treated with oxygen and haemostatic agents. The patient recovered quickly without any significant sequela and was discharged.

Keyword

Carcinoma, Hepatocellular; transcatheter arterial chemoembolization; Pulmonary Embolism; lipiodol

MeSH Terms

Aged
Carcinoma, Hepatocellular
Dyspnea
Embolism
Ethiodized Oil
Hemoptysis
Humans
Oxygen
Pulmonary Embolism
Thorax
Ethiodized Oil
Oxygen

Figure

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  Figure 1 Chest radiography. (A) Prior to TACE, the chest X-ray is normal findings. (B) On admission, the chest X-ray shows ill-defined multiple opacity in the right lower lung field. (C) On the seventh day, the chest X-ray shows a slight decrease in the opacity in the right lower lung field. TACE: transcatheter arterial chemoembolization.

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  Figure 2 Chest CT. (A) Pre-contrast CT scan shows small amount of pleural effusion and consolidation with internal high density in the right lower lobe. (B) After 1 month, follow-up CT scan shows the disappearance of pleural effusion and greater reduction in the consolidation with internal high density. CT: computed tomography.

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  Figure 3 Bronchoscopic findings. The bleeding in the right lower lobe bronchus can be seen.

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  Figure 4 Angiography findings. The angiographic image shows a fistula between the right inferior phrenic artery branch and the right pulmonary artery.

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