Colon Perforation Secondary to Radiofrequency Ablation of Hepatic Tumor

We present a case of nasopharyngeal carcinoma, which was treated by radiotherapy combined with chemotherapy. Hepatic metastases was noted, and thus referred to our department for Radiofrequency (RF) ablation therapy. Pain was noted after the procedure and was given analgesics. However, the pain persisted with direct and rebound tenderness over the whole abdomen on the 4th day after ablation. CT scan of the abdomen revealed focal free air and inflammatory strandings on the right pericolic and adjacent mesenteric fat plane associated with mucosal disruption at the hepatic flexure of colon. Iatrogenic colon perforation secondary to RF ablation was diagnosed and he underwent right hemicolectomy with side-to-side anastomosis. Post-operative course was smooth except of intermittent fever and anemia. Antiobiotic therapy and blood transfusion were given and he was discharged as improved 13th days post-operatively. We report a case of colon perforation secondary to RF ablation of metastatic hepatic tumor. We emphasize that the performing physician should be aware and careful selection of patient is necessary to avoid this complication. The radiologist must be familiar with the various imaging features of this complication for early diagnosis and appropriate management.