Emergency embolization in the treatment of ruptured hepatocellular carcinoma following transcatheter arterial chemoembolization.
OBJECTIVE
Rupture of hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE) is a rare and life-threatening complication. The purpose of the present study was to evaluate the utility of emergency embolization for treatment of ruptured HCC following TACE.


METHODS
Five patients developed rupture of tumor after TACE in 1005 patients of HCC from October 2007 to February 2010, and were studied retrospectively. Emergency selective arterial embolization was performed in all 5 patients because of intractable hemorrhage in the peritoneal cavity or around the liver that could not be controlled by conservative method. The mean hemoglobin level before embolization was 75.6 g/L +/- 20.7 (mean +/- standard deviation).


RESULTS
Hepatic angiography did not revealed extravasation of contrast from the tumor in all 5 patients with rupture of HCC following TACE. After selective embolization of feeding arteries of the liver tumor, intraperitoneal bleeding from HCC was stopped immediately in all patients. The mean hemoglobin level after embolization in 48 hours was 102.6 g/L +/- 3.5. No severe complication related to emergency embolization was found after treatment.


CONCLUSIONS
Emergency arterial embolization is effective for hemostasis of ruptured HCC following TACE in patients with hemodynamically unstable condition.
Sun
Jun-Hui
JH
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Wang
Li-Gang
LG
Bao
Hai-Wei
HW
Lou
Jian-Liang
JL
Cai
Li-Xia
LX
Wu
Chao
C
Chen
Li-Ming
LM
Zheng
Shu-Sen
SS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D004630:Emergencies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous