Korean J Gastroenterol.  2011 Sep;58(3):149-152. 10.4166/kjg.2011.58.3.149.

A Case of Hepaticoduodenal Fistula Development after Transarterial Chemoembolization in Patient with Hepatocellular Carcinoma

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. dyk1025@yuhs.ac

Abstract

Transarterial chemoembolization (TACE) is recommended as one of the first line therapy for unresectable hepatocellular carcinoma (HCC). Rupture of HCC following TACE is a rare and potentially fatal complication. We report a case of hepaticoduodenal fistula with ruptured HCC and liver abscess complicated by TACE. A 52-year-old male was treated by TACE three times, followed by radiation therapy and systemic chemotherapy. 30 days after the last TACE, right upper quadrant pain of abdomen was developed. About 1 month later, computed tomography of abdomen showed ruptured HCC with debris containing liver abscess and hepaticoduodenal fistula. Esophagogastroduodenoscopy revealed hepaticoduodenal fistula and hepatic parenchyme covered with exudate. The patient was managed with supportive care, but the hepaticoduodenal fistula persisted.

Keyword

Hepaticoduodenal fistula; Hepatocellular carcinoma; Transarterial chemoembolization

MeSH Terms

Carcinoma, Hepatocellular/radiotherapy/*therapy
Chemoembolization, Therapeutic/*adverse effects
Endoscopy, Digestive System
Gastric Fistula/*etiology
Humans
Liver Abscess/etiology
Liver Diseases/*etiology
Liver Neoplasms/radiotherapy/*therapy
Male
Middle Aged
Rupture, Spontaneous/etiology
Tomography, X-Ray Computed
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