title: [A case of intrahepatic bile duct necrosis following hepatic arterial infusion chemotherapy].
abstract: A 51-year-old man underwent partial hepatectomy in July 2000 for metastatic liver tumor after gastrectomy for gastric cancer. He received seven cycles of hepatic arterial infusion with mitomycin C 20 mg during induced hypertension with angiotensin II from October 2000 to April 2001. His body temperature sometimes rose above 38 degrees C in June and jaundice appeared in August 2001. Blood biochemistry tests showed an elevated value of alkaline phosphatase, gamma-glutamyl transpepsidase and total bilirubin. Based on an enhanced CT scan of the liver showing a low-density area along intrahepatic biliary tracts and hepatic arteriography showing stenosis of the proper hepatic artery, we diagnosed bile duct necrosis and hepatic necrosis. Bile duct necrosis is a serious complication in arterial infusion chemotherapy, and the infusion chemotherapy should be suspended or the dose should be reduced for patients with abnormalities shown by hepato-biliary function tests.
authors.affiliation: Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Arai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Toshio
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D009336:Necrosis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase