经导管动脉化疗栓塞治疗复发性肝细胞癌后胆固醇结晶栓塞致缺血性小肠穿孔：一例报告
Ischemic small bowel perforation caused by cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma: a case report.
作者信息
Hamura Ryoga, Haruki Koichiro, Iwase Ryota, Furukawa Kenei, Shirai Yoshihiro, Onda Shinji, Gocho Takeshi, Ikegami Toru
机构信息
Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
出版信息
Surg Case Rep. 2021 Feb 10;7(1):45. doi: 10.1186/s40792-021-01116-8.
BACKGROUND
Cholesterol crystal embolism (CCE) following transcatheter arterial chemoembolization (TACE) is rare.
CASE PRESENTATION
A 71-year-old man underwent TACE for recurrence of hepatocellular carcinoma (HCC). On postoperative day (POD) 5, he developed abdominal pain and fever. Computed tomography revealed intraperitoneal free air. The patient was diagnosed with gastrointestinal perforation with peritonitis, for which partial intestinal resection and covering ileostomy were performed. Histological examination revealed perforation of the small intestine caused by CCE. The patient made a satisfactory recovery and was discharged on POD 30. The patient showed no recurrence of cholesterol crystal embolism or HCC for 2 years after surgery.
CONCLUSION
We reported a successfully treated case of ischemic small bowel perforation due to cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent HCC.
背景
经导管动脉化疗栓塞术（TACE）后发生胆固醇结晶栓塞（CCE）较为罕见。
病例报告
一名71岁男性因肝细胞癌（HCC）复发接受了TACE治疗。术后第5天，他出现腹痛和发热。计算机断层扫描显示腹腔内有游离气体。该患者被诊断为胃肠道穿孔伴腹膜炎，为此进行了部分肠切除术和覆盖性回肠造口术。组织学检查显示小肠穿孔由CCE引起。患者恢复良好，术后第30天出院。术后2年，患者未出现胆固醇结晶栓塞或HCC复发。
结论
我们报告了一例经导管动脉化疗栓塞术治疗复发性HCC后因胆固醇结晶栓塞导致缺血性小肠穿孔并成功治疗的病例。
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