Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report
Drug-eluting bead transarterial chemoembolization (DEB-TACE) is a well-established, minimally invasive interventional treatment for nonresectable hepatocellular carcinoma (HCC). Generally, TACE is regarded as safe and effective with a low complication rate. However, remote gastrointestinal ischemia...
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2018-06-01
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doaj-f70ede0f0139470791b87a0bdc1c16d02020-11-24T22:25:47ZengKarger PublishersCase Reports in Gastroenterology1662-06312018-06-0112235235910.1159/000490604490604Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case ReportNatascha RoehlenRichard F. KnoopKatharina LaubnerJochen SeufertHenning SchwachaRobert ThimmeAndreas FischerDrug-eluting bead transarterial chemoembolization (DEB-TACE) is a well-established, minimally invasive interventional treatment for nonresectable hepatocellular carcinoma (HCC). Generally, TACE is regarded as safe and effective with a low complication rate. However, remote gastrointestinal ischemia due to the carryover of embolic material into visceral arteries is a rare but serious complication of TACE. In this report, we present a case of duodenal ulceration with contained perforation and severe necrotizing pancreatitis after TACE in a patient with nonresectable HCC and underlying hepatitis C virus associated with Child-Pugh stage B liver cirrhosis. This patient showed, for the first time, complete endoscopic and clinical recovery within 2 months of conservative treatment. Considering the high mortality rate from surgical intervention in all previously reported patients, the significant recovery potential demonstrated by our case suggests conservative treatment with antibiotics and parenteral nutrition combined with close clinical, radiological, and endoscopic monitoring should be considered in all clinically stable patients without signs of peritonism or septic sequelae.https://www.karger.com/Article/FullText/490604Hepatocellular carcinomaTransarterial chemoembolizationGastrointestinal ischemiaDuodenal ulcerationEsophagogastroduodenoscopy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natascha Roehlen Richard F. Knoop Katharina Laubner Jochen Seufert Henning Schwacha Robert Thimme Andreas Fischer |
spellingShingle |
Natascha Roehlen Richard F. Knoop Katharina Laubner Jochen Seufert Henning Schwacha Robert Thimme Andreas Fischer Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report Case Reports in Gastroenterology Hepatocellular carcinoma Transarterial chemoembolization Gastrointestinal ischemia Duodenal ulceration Esophagogastroduodenoscopy |
author_facet |
Natascha Roehlen Richard F. Knoop Katharina Laubner Jochen Seufert Henning Schwacha Robert Thimme Andreas Fischer |
author_sort |
Natascha Roehlen |
title |
Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report |
title_short |
Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report |
title_full |
Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report |
title_fullStr |
Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report |
title_full_unstemmed |
Ischemic Duodenal Ulceration after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Case Report |
title_sort |
ischemic duodenal ulceration after transarterial chemoembolization for hepatocellular carcinoma: a case report |
publisher |
Karger Publishers |
series |
Case Reports in Gastroenterology |
issn |
1662-0631 |
publishDate |
2018-06-01 |
description |
Drug-eluting bead transarterial chemoembolization (DEB-TACE) is a well-established, minimally invasive interventional treatment for nonresectable hepatocellular carcinoma (HCC). Generally, TACE is regarded as safe and effective with a low complication rate. However, remote gastrointestinal ischemia due to the carryover of embolic material into visceral arteries is a rare but serious complication of TACE. In this report, we present a case of duodenal ulceration with contained perforation and severe necrotizing pancreatitis after TACE in a patient with nonresectable HCC and underlying hepatitis C virus associated with Child-Pugh stage B liver cirrhosis. This patient showed, for the first time, complete endoscopic and clinical recovery within 2 months of conservative treatment. Considering the high mortality rate from surgical intervention in all previously reported patients, the significant recovery potential demonstrated by our case suggests conservative treatment with antibiotics and parenteral nutrition combined with close clinical, radiological, and endoscopic monitoring should be considered in all clinically stable patients without signs of peritonism or septic sequelae. |
topic |
Hepatocellular carcinoma Transarterial chemoembolization Gastrointestinal ischemia Duodenal ulceration Esophagogastroduodenoscopy |
url |
https://www.karger.com/Article/FullText/490604 |
work_keys_str_mv |
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