Son Min Young, Han Byung Hoon, Lee Sang Uk, Yun Byung Cheol, Seo Kwang Il, Huh Jin Do
Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Departments of Radiology, Kosin University College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2020 Jun 25;75(6):351-355. doi: 10.4166/kjg.2020.75.6.351.
Transarterial chemoembolization (TACE) is a common treatment for unresectable hepatocellular carcinoma (HCC). The most common complications after TACE are non-specific symptoms called post-embolization syndrome, such as abdominal pain or fever. Rare complications, such as liver failure, liver abscess, sepsis, pulmonary embolism, cholecystitis, can also occur. On the other hand, gallbladder perforation is quite rare. This paper reports a case of gallbladder perforation following TACE. A 76-year-old male with a single 9-cm-sized HCC underwent TACE. Five days after TACE, he developed persistent right upper quadrant pain and ileus. An abdomen CT scan confirmed gallbladder perforation with bile in the right paracolic gutter and pelvic cavity. Percutaneous transhepatic gallbladder drainage was performed with the intravenous administration of antibiotics. After 1 month, the patient underwent right hemihepatectomy and cholecystectomy. Physicians should consider the possibility of gallbladder perforation, which is a rare complication after TACE, when unexplained abdominal pain persists.
经动脉化疗栓塞术（TACE）是不可切除肝细胞癌（HCC）的常见治疗方法。TACE术后最常见的并发症是称为栓塞后综合征的非特异性症状，如腹痛或发热。也可能发生罕见的并发症，如肝衰竭、肝脓肿、败血症、肺栓塞、胆囊炎。另一方面，胆囊穿孔相当罕见。本文报告一例TACE术后胆囊穿孔病例。一名76岁男性，患有一个9厘米大小的单发HCC，接受了TACE治疗。TACE术后五天，他出现持续的右上腹疼痛和肠梗阻。腹部CT扫描证实胆囊穿孔，胆汁流入右结肠旁沟和盆腔。在静脉使用抗生素的同时进行了经皮经肝胆囊引流。1个月后，患者接受了右半肝切除术和胆囊切除术。当出现无法解释的持续性腹痛时，医生应考虑胆囊穿孔的可能性，这是TACE术后一种罕见的并发症。
