Ewha Med J.  2013 Mar;36(1):62-66. 10.12771/emj.2013.36.1.62.

Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report

• Jo YW
• Lee JM
• Choi JY
• Lew DH
• Cha RR
• Oh HW
• Kim HJ
• Min HJ
• Kim HJ
• Jung WT
• Lee OJ
• Ha CY
• Yi SY

• KMID: 2284017
• DOI: http://doi.org/10.12771/emj.2013.36.1.62

Abstract

Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.

Keyword

Acute respiratory distress syndrome; Chemoembolization; Hepatocellular carcinoma

MeSH Terms

Carcinoma, Hepatocellular
Embolism
Ethiodized Oil
Humans
Masks
Oximetry
Oxygen
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Ethiodized Oil
Oxygen

Figure

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  Fig. 1 Abdomen computed tomography showes huge hepatocellular carcinoma involving right hepatic lobe.

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  Fig. 2 Common hepatic artery angiography showes huge hypervascular tumor staining in right hepatic lobe.

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  Fig. 3 (A) Initial chest x-ray shows reticular opacity in both lower lobes. (B) chest x-ray after TACE shows transcatheter arterial chemoembolization (TACE) multifocal bilateral patchy ground glass opacity.

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  Fig. 4 Chest computed tomography shows multifocal crazy paving pattern and interlobular septal thickening in both lung, and honeycombing in both lower lobes.

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