title: A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma.
abstract: Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Song-I
authors.initials: SI
authors.lastname: Bae
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.forename: Jong Mee
authors.initials: JM
authors.lastname: Lee
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lee
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Lee
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Suh
authors.forename: Eileen L
authors.initials: EL
authors.lastname: Yoon
authors.forename: Hae Rim
authors.initials: HR
authors.lastname: Kim
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Byun
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Seo
mesh_terms: D000038:Abscess / Q000382:microbiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D016971:Citrobacter freundii / Q000302:isolation & purification; D004322:Drainage; D024901:Drug Resistance, Multiple, Bacterial; D004756:Enterobacteriaceae Infections / Q000188:drug therapy; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications* / Q000628:therapy*; D008297:Male; D009336:Necrosis / Q000175:diagnosis* / Q000209:etiology; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute necrotizing pancreatitis; Carcinoma, Hepatocellular; Therapeutic chemoembolization