title: Hepatoduodenal fistula formation following transcatheter arterial chemoembolization and radiotherapy for hepatocellular carcinoma: treatment with endoscopic Histoacryl injection.
abstract: A 71-year-old male patient was readmitted to our hospital 1 month after discharge because of relapse of abdominal pain. He had been diagnosed with hepatocellular carcinoma (HCC) 1 year prior and had undergone repeated transcatheter arterial chemoembolization and radiotherapy. During the last hospitalization, he was diagnosed with a liver abscess complicated by previous treatments for HCC and was treated with intravenous antibiotics and abscess aspiration. Follow-up abdominal computed tomography revealed a liver abscess with a duodenal fistula, which was successfully treated with endoscopic Histoacryl injection into the fistula. Liver abscesses with duodenal fistulas rarely occur, but they are intractable and possibly fatal in patients with HCC. In the literature, they have frequently been managed only with abscess treatment without fistula management. We herein report the first case of a patient with a liver abscess complicated by a fistula between the duodenum and the abscess, which was treated with endoscopic Histoacryl injection.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jaryong
authors.initials: J
authors.lastname: Jeon
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Joonseong
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hongseok
authors.initials: H
authors.lastname: Yoo
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Taek Kyu
authors.initials: TK
authors.lastname: Park
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dongmo
authors.initials: D
authors.lastname: Je
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyemin
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000038:Abscess / Q000150:complications*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004378:Duodenal Diseases / Q000209:etiology* / Q000628:therapy; D004659:Enbucrilate / Q000008:administration & dosage*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000628:therapy; D008107:Liver Diseases / Q000209:etiology* / Q000628:therapy; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects
chemical_list: D004659:Enbucrilate
keywords: Abscess; Carcinoma, hepatocellular; Endoscopy; Fistula