DOI QR코드

DOI QR Code

간세포암 치료로 고주파열치료 시행 후 발생한 간대장누공 1예

Hepatocolic Fistula after Radiofrequency Ablation for Hepatocellular Carcinoma

  • 강민규 (건양대학교 의과대학 소화기내과학교실) ;
  • 이태희 (건양대학교 의과대학 소화기내과학교실) ;
  • 나운태 (건양대학교 의과대학 소화기내과학교실) ;
  • 정지현 (건양대학교 의과대학 소화기내과학교실) ;
  • 임동혁 (건양대학교 의과대학 소화기내과학교실) ;
  • 이만 (건양대학교 의과대학 소화기내과학교실) ;
  • 강영우 (건양대학교 의과대학 소화기내과학교실)
  • Kang, Min-Gyu (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Lee, Tae-Hee (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Na, Woon-Tae (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Jeong, Ji-Hyun (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Lim, Dong-Hyuk (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Lee, Mahn (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine) ;
  • Kang, Young-Woo (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Konyang University College of Medicine)
  • 발행 : 2012.10.01

초록

저자들은 58세 남자 환자에서 간세포암 치료를 위해 고주파 열치료 후 발생한 간농양과 이로 인해 합병된 것으로 추정되는 간대장누공 1예를 경험하고 치료하였기에 문헌고찰과 같이 보고하고자 한다.

Radiofrequency ablation (RFA) is a relatively safe therapy for patients with hepatocellular carcinoma (HCC); however, complications are not unknown. A hepatocolic fistula is a rare complication after RFA. We report a case of a hepatocolic fistula following a liver abscess after RFA for HCC in a 58-year-old male. The patient was diagnosed with HCC and liver cirrhosis from hepatitis B infection 3 years prior to admission. The HCC was in segment 6 of the liver and was treated with transarterial chemoembolization and RFA. One month after the second RFA, he was diagnosed with a liver abscess, for which he was treated with antibiotics for 2 months, but continued to have intermittent fever and chills. We made a diagnosis of hepatocolic fistula using colonoscopy, fluoroscopy, and liver dynamic computed tomography. The patient underwent a surgical procedure after antibiotic therapy. Although a hepatocolic fistula is a rare complication following RFA, clinicians should be aware of its existence.

키워드

참고문헌

  1. Park SG, Park SJ, Koo HS, et al. Biliary-duodenal fistula following radiofrequency ablation therapy for hepatocellular carcinoma. Korean J Gastroenterol 2008;51:199-203.
  2. Rhim H, Dodd GD 3rd, Chintapalli KN, et al. Radiofrequency thermal ablation of abdominal tumors: lessons learned from complications. Radiographics 2004;24:41-52. https://doi.org/10.1148/rg.241025144
  3. Rhim H. Complications of radiofrequency ablation in hepatocellular carcinoma. Abdom Imaging 2005;30:409-418. https://doi.org/10.1007/s00261-004-0255-7
  4. Lim DM, Kim H, Wee DC, et al. Hepatocolic fistula : rare complication of ruptured pyogenic abscess. Korean J Gastroenterol 1994;26:596-600.
  5. Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 2003;226:441-451. https://doi.org/10.1148/radiol.2262012198
  6. Rhim H, Yoon KH, Lee JM, et al. Major complications after radio-frequency thermal ablation of hepatic tumors: spectrum of imaging findings. Radiographics 2003;23: 123-134. https://doi.org/10.1148/rg.231025054
  7. Kim YM, Lee TH, Jung SH, et al. Hepatic abscess that formed secondary to fish bone and had a fistula with the ascending colon. Dig Dis Sci 2007;52:3515-3518. https://doi.org/10.1007/s10620-006-9198-x
  8. Satoh H, Matsuyama S, Mashima H, Imoto A, Hidaka K, Hisatsugu T. A case of hepatocolic fistula after percutaneous drainage for a gas-containing pyogenic liver abscess. J Gastroenterol 1994;29:782-785. https://doi.org/10.1007/BF02349288
  9. Tandon N, Karak PK, Mukhopadhyay S, Kumar V. Amoebic liver abscess: rupture into retroperitoneum. Gastrointest Radiol 1991;16:240-242. https://doi.org/10.1007/BF01887355

피인용 문헌

  1. Biliary-Colonic Fistula after Hepatectomy Treated by Colonoscopic Clipping vol.23, pp.1, 2012, https://doi.org/10.15279/kpba.2018.23.1.36