title: Case report. Spontaneous cholecystocolic fistula and locoregional liver tumour ablation: a cautionary tale.
abstract: A liver abscess is a feared and potentially fatal complication following transarterial chemoembolisation (TACE) and radiofrequency ablation (RFA) of liver tumours. Iatrogenic bilio-enteric communications, such as bilio-enteric anastomosis, sphincterotomy and biliary stents, are considered major risk factors and are due to bacterial colonisation of the biliary tree with enteric flora. Naturally occurring spontaneous cholecysto-enteric fistula poses a similar risk as its iatrogenic counterparts but is rarely described in the literature. We present a case where abscess formation complicated a combined TACE and RFA in an unrecognised cholecystocolic fistula.
authors.affiliation: Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore. druei@yahoo.com
authors.forename: U
authors.initials: U
authors.lastname: Pua
authors.forename: E M
authors.initials: EM
authors.lastname: Merkle
mesh_terms: D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D017115:Catheter Ablation / Q000009:adverse effects*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008100:Liver Abscess / Q000209:etiology / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D014057:Tomography, X-Ray Computed
references.citation: Radiology. 2003 Feb;226(2):441-51
references.pmid: 12563138
references.citation: J Vasc Interv Radiol. 2001 Aug;12(8):965-8
references.pmid: 11487677
references.citation: J Hepatobiliary Pancreat Surg. 2009;16(1):8-18
references.pmid: 19089311
references.citation: Dig Dis Sci. 1996 Dec;41(12):2332-9
references.pmid: 9011438
references.citation: Gastroenterol Clin Biol. 2006 Jun-Jul;30(6-7):823-7
references.pmid: 16885864
references.citation: Radiology. 1996 Jan;198(1):33-40
references.pmid: 8539401
references.citation: J Vasc Interv Radiol. 2002 Nov;13(11):1163-6
references.pmid: 12427817
references.citation: Radiographics. 2003 Jan-Feb;23(1):123-34; discussion 134-6
references.pmid: 12533647
references.citation: Cardiovasc Intervent Radiol. 1993 Sep-Oct;16(5):325-7
references.pmid: 8269433
references.citation: J Vasc Interv Radiol. 2003 Dec;14(12):1535-42
references.pmid: 14654488