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. 2017 Jun 5;130(11):1314-1319.
doi: 10.4103/0366-6999.206345.

A Case Series of Liver Abscess Formation after Transcatheter Arterial Chemoembolization for Hepatic Tumors

Wei Sun  1 , Fei Xu  1 , Xiao Li  1 , Chen-Rui Li  1
Affiliations

A Case Series of Liver Abscess Formation after Transcatheter Arterial Chemoembolization for Hepatic Tumors

Wei Sun et al. Chin Med J (Engl). .

Abstract

Background: Liver abscess is a serious complication following transcatheter arterial chemoembolization (TACE). Much attention has been paid to this condition as it may interfere with the treatment process and result in a poor prognosis of the patient. This study aimed to analyze the causes of liver abscess, a complication, after TACE for hepatic tumors and to summarize management approaches.

Methods: From June 2012 to June 2014, of 1480 consecutive patients who underwent TACE at our hospital, five patients developed liver abscess after TACE procedures for hepatic tumors. Of the five patients, each receiving conventional TACE, one underwent three sessions, two underwent two sessions, and the remaining two underwent one session of TACE. Demographic and clinical characteristics, together with management approaches and prognosis, were collected through a review of medical records.

Results: These five patients were confirmed to have post-TACE liver abscess through clinical manifestations, laboratory, and imaging tests. After percutaneous drainage and anti-inflammatory treatments, the symptoms present in four patients with liver abscess significantly improved as evidenced by shrinkage or disappearance of the abscess cavity, and the patients recovered completely after sufficient drainage. The remaining patient experienced recurrent symptoms and abdominal abscess, achieved no significant improvement after treatment, and eventually died of severe infection and multiple organ failures.

Conclusions: TACE must be implemented with extreme caution to avoid liver abscess. An effective management relies on an early diagnosis, prompt use of sufficient doses of appropriate antibiotics, and active implementation of abscess incision, drainage, and aspiration.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Imaging results of a 41-year-old male with primary HCC. (a) CT image after the first TACE session; (b) DSA image after the second TACE session; (c) CT image after two TACE sessions; (d) X-ray image after percutaneous transhepatic external drainage of liver abscess. HCC: Hepatocellular carcinoma; CT: Computed tomography; TACE: Transcatheter arterial chemoembolization; DSA: Digital subtraction angiography.
Figure 2
Figure 2
Imaging results of a 38-year-old male with primary HCC. (a) CT image after two TACE sessions; (b) CT image after three TACE sessions; (c) X-ray image after percutaneous transhepatic external drainage of liver abscess; (d) CT image after percutaneous transhepatic external drainage of liver abscess. HCC: Hepatocellular carcinoma; CT: Computed tomography; TACE: Transcatheter arterial chemoembolization.
See this image and copyright information in PMC

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