Gallbladder perforation following transarterial chemoembolisation; a rare but serious complication. Issue 2 (21st February 2013)

• Record Type: Journal Article
• Authors: Lim, Eu Jin; Spanger, Manfred; Lubel, John S
• Is Part Of: Frontline gastroenterology. Volume 4:Issue 2(2013)
• Page Start: 135
• Page End: 137
• Publication Date: 2013-02-21
• Subjects: Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1136/flgastro-2012-100216
• Languages: English
• ISSNs: 2041-4137

Abstract

Abstract : Transarterial chemoembolisation (TACE) is the mainstay of treatment for large or multifocal hepatocellular carcinoma (HCC). However, this procedure is not without potential complications. We report the case of a 72-year-old man with cirrhosis with HCC treated by TACE using drug-eluting beads. He developed persistent fever and severe right upper quadrant pain post-procedure. CT abdomen revealed a large fluid collection closely abutting the gallbladder and tracking inferiorly along the right flank. This fluid collection originated from the gallbladder and contained locules of gas with a contrast-enhancing wall, consistent with an infected biloma. These imaging findings confirmed gallbladder perforation complicating TACE. The development of gallbladder perforation post-TACE from acute ischaemic cholecystitis producing gallbladder wall necrosis is exceedingly rare. The presence of gallbladder perforation must be recognised in patients with persisting symptoms and imaging evidence of a perihepatic fluid collection because specific treatment with intravenous antibiotics and percutaneous drainage of the biloma is necessary.