The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Hepatoduodenal fistula formation following transcatheter arterial chemoembolization and radiotherapy for hepatocellular carcinoma: treatment with endoscopic Histoacryl injection

  • Jeon, Jaryong (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Joonseong (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yoo, Hongseok (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Taek Kyu (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Je, Dongmo (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeong, Hyemin (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Kwang Hyuck (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2012.05.31
  • Accepted : 2012.06.29
  • Published : 2014.01.01
⟨ Previous Next ⟩

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.

Keywords

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011;61:69-90. https://doi.org/10.3322/caac.20107
  2. Lee JS. Advances in the treatment of hepatocellular carcinoma. Korean J Med 2009;77:290-297.
  3. Wang CY, Leung SW, Wang JH, Yu PC, Wang CC. Delayed spontaneous hepatogastric fistula formation following transcatheter arterial embolisation and radiotherapy for hepatocellular carcinoma. Br J Radiol 2009;82:e105-e107. https://doi.org/10.1259/bjr/63705954
  4. Meng MB, Cui YL, Lu Y, et al. Transcatheter arterial chemoembolization in combination with radiotherapy for unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Radiother Oncol 2009;92:184-194. https://doi.org/10.1016/j.radonc.2008.11.002
  5. Marelli L, Stigliano R, Triantos C, et al. Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol 2007;30:6-25. https://doi.org/10.1007/s00270-006-0062-3
  6. 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.
  7. Park H, Kim SU, Choi J, et al. Hepatogastric fistula caused by direct invasion of hepatocellular carcinoma after transarterial chemoembolization and radiotherapy. Korean J Hepatol 2010;16:401-404. https://doi.org/10.3350/kjhep.2010.16.4.401
  8. Kim JY, Kwon YH, Lee SJ, et al. Abscesso-colonic fistula following radiofrequency ablation therapy for hepatocellular carcinoma: a case successfully treated with Histoacryl embolization. Korean J Gastroenterol 2011;58:270-274. https://doi.org/10.4166/kjg.2011.58.5.270
  9. Park YH, Kang SH, Kim SU, et al. A case of hepaticoduodenal fistula development after transarterial chemoembolization in patient with hepatocellular carcinoma. Korean J Gastroenterol 2011;58:149-152. https://doi.org/10.4166/kjg.2011.58.3.149
  10. Ong GY, Changchien CS, Lee CM, et al. Liver abscess complicating transcatheter arterial embolization: a rare but serious complication: a retrospective study after 3878 procedures. Eur J Gastroenterol Hepatol 2004;16:737-742. https://doi.org/10.1097/01.meg.0000108361.41221.8c

Cited by

  1. Utility of endoscopic ultrasound and endoscopy in diagnosis and management of hepatocellular carcinoma and its complications: What does endoscopic ultrasonography offer above and beyond conventional c vol.10, pp.2, 2014, https://doi.org/10.4253/wjge.v10.i2.56
  2. Successful endoscopic treatment of hepatoduodenal fistula formed during sorafenib treatment for hepatocellular carcinoma with duodenal invasion vol.60, pp.3, 2014, https://doi.org/10.2957/kanzo.60.91
  3. Spontaneous hepaticoduodenal fistula following extended right hemihepatectomy vol.89, pp.12, 2019, https://doi.org/10.1111/ans.14790
  4. Recurrent hepatogastric fistula during lenvatinib therapy for advanced hepatocellular carcinoma managed by over-the-scope clip closure: a case report vol.16, pp.2, 2014, https://doi.org/10.2185/jrm.2020-044
  5. Hepatoduodenal fistula closure diagnosed and characterized Ecoendoscopically (EUS) and managed by OTSC CLIP OVESCO: A case report vol.84, pp.None, 2014, https://doi.org/10.1016/j.ijscr.2021.106093