Ischemic small bowel perforation caused by cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma: a case report.
Ischemic small bowel perforation caused by cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma: a case report.
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DOI：
10.1186/s40792-021-01116-8
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发表时间：
2021-02-10
影响因子：
0.8
通讯作者：
Ikegami T
中科院分区：
文献类型：
--
作者：
Hamura R;Haruki K;Iwase R;Furukawa K;Shirai Y;Onda S;Gocho T;Ikegami T
经导管动脉化疗栓塞 (TACE) 后发生胆固醇晶体栓塞 (CCE) 的情况很少见。一名 71 岁男性因肝细胞癌 (HCC) 复发接受 TACE 治疗。术后第 5 天（POD），他出现腹痛和发烧。计算机断层扫描显示腹膜内有游离空气。患者被诊断为胃肠道穿孔合并腹膜炎，并进行了部分肠切除和覆盖回肠造口术。组织学检查发现 CCE 引起的小肠穿孔。患者恢复满意，并于术后第 30 日出院。术后 2 年，患者未出现胆固醇结晶栓塞或肝癌复发。我们报道了一例因复发性肝癌经导管动脉化疗栓塞术后胆固醇结晶栓塞导致缺血性小肠穿孔的成功治疗病例。
Cholesterol crystal embolism (CCE) following transcatheter arterial chemoembolization (TACE) is rare. 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. We reported a successfully treated case of ischemic small bowel perforation due to cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent HCC.
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