A Case of Necrotizing Liver Abscess and Bile Duct Necrosis FollowingHepatic Arterial Chemoembolization in Hepatocelluar Carcinoma

A Case of Necrotizing Liver Abscess and Bile Duct Necrosis Following Hepatic Arterial Chemoembolization in Hepatocelluar Carcinoma Gyu Jung, M.D., Jeong Wook Kim, M.D., Sang Jin Kim, M.D. Jun Hyung Joe, M.D., Jong Beum Lee, M.D.§, Jae Gyu Kim, M.D. Joongwon Park, M.D., Sae Kyung Chang, M.D., Byung Cheol Yoo M.D. and Sill Moo Park M.D. Department of Internal Medicine and Radiology,§College of Medicine, Chung-Ang University, Seoul, Korea Transcatheter arterial chemoembolization (TACE) is widely used in the treatment of hepatocellular carcinomas. We report a case of multiple liver abscess with bile duct necrosis following gallbladder infarction after TACE in a patient with hepatocellular carcinoma. A 62year old man, with four cm sized hepatocellular carcinoma in right lobe, was treated by TACE for six times during 18 months. Two days after the last TACE, acute cholecystitis occurred and antibiotics were used until the recovery of cholecystitis. After two months, abdominal CT scan revealed a gas containing liver abscess and percutaneous transhepatic drainage was performed. Cholangiography via drainage catheter showed findings of bile duct necrosis. Antibiotics sensitive to the causative organism were administered intravenously. However, the abscess persisted despite of treatment for three months. (Korean J Hepatol 1999;5:348-352)