The Korean Journal of Gastroenterology  2011;58(3):149-152

doi:10.4166/kjg.2011.58.3.149

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

Yoon Hea PARK 1 ; Se Hun KANG ; Seung Up KIM ; Do Young KIM ; Jun Yong PARK ; Sang Hoon AHN ; Kwang Hyub HAN ; Chae Yoon CHON

Affiliations

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Keywords

Hepaticoduodenal fistula; Hepatocellular carcinoma; Transarterial chemoembolization

Country

Republic of Korea

Language

Korean

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.