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

• DOI: 10.3350/cmh.2012.18.3.321
• Publication Date: 2012-10-05T12:39:00Z
• Authors: Song-I Bae; Jong Eun Yeon; Jong Mee Lee; Ji Hoon Kim; Hyun Jung Lee; Sun Jae Lee; Sang Jun Suh; Eileen L. Yoon; Hae Rim Kim; Kwan Soo Byun; Tae-Seok Seo
• Keywords: Liver Cirrhosis; Male; Carcinoma, Hepatocellular; Case Report; RC799-869; Necrosis; 03 medical and health sciences; 0302 clinical medicine; Drug Resistance, Multiple, Bacterial; Klebsiella; Humans; Acute necrotizing pancreatitis; Chemoembolization, Therapeutic; Aged; Cholangiopancreatography, Endoscopic Retrograde; Therapeutic chemoembolization; Liver Neoplasms; Enterobacteriaceae Infections; Diseases of the digestive system. Gastroenterology; Hepatitis B; Abscess; Anti-Bacterial Agents; Klebsiella Infections; 3. Good health; Citrobacter freundii; Pancreatitis; Drainage; Tomography, X-Ray Computed

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.