Document Detail

Acute respiratory distress syndrome after transcatheter arterial chemoembolization of hepatocellular carcinomas.
MedLine Citation:
PMID:  19826242     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acute respiratory distress syndrome (ARDS) associated with pulmonary lipiodol embolism is a rare complication of transcatheter arterial chemoembolization (TACE). We performed a survey of ARDS associated with pulmonary lipiodol embolism after TACE. METHODS: A retrospective analysis of the cases of all patients with hepatic tumors who received transcatheter arterial embolization or TACE between January 2006 and December 2006 was performed. The diagnosis of pulmonary lipiodol embolism was confirmed by chest computed tomography (CT). RESULTS: The diagnosis of ARDS associated with pulmonary lipiodol embolism was confirmed in 4 patients. All had large (> or =5 cm) and hypervascular tumors. There was no evidence of hepatocellular carcinoma arteriovenous shunting in any of our patients as determined by angiography and multidetector CT. The volumes of lipiodol infused in the 4 patients were 50, 20, 30, and 20 mL. Only 2 patients received injections of carcinostatic agents. The onset of respiratory symptoms occurred between 1 hour and 4 days after TACE. Respiratory symptoms consisted of dyspnea and tachypnea. Chest CT scans revealed linear high-density shadows, suggestive of lipiodol retention in both lungs of all patients. CONCLUSION: Pulmonary lipiodol embolism after TACE can occur within a short time frame. Whether or not there is intrahepatic arteriovenous shunting detected by multidetector CT and angiography, clinicians should avoid high doses of iodized oil and carcinostatic agents. We suggest that CT should be used for the diagnosis of pulmonary lipiodol embolism.
Geng-Chin Wu; Wann-Cherng Perng; Chien-Wen Chen; Chih-Feng Chian; Chung-Kan Peng; Wen-Lin Su
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  338     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-17     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-60     Citation Subset:  AIM; IM    
Division of Pulmonary Medicine, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Lungtan, Taoyuan, Taiwan.
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MeSH Terms
Aged, 80 and over
Antibiotics, Antineoplastic / administration & dosage,  therapeutic use
Carcinoma, Hepatocellular / therapy*
Catheterization, Peripheral
Chemoembolization, Therapeutic / methods*
Contrast Media / administration & dosage,  adverse effects*
Doxorubicin / administration & dosage,  therapeutic use
Infusions, Intralesional
Iodized Oil / administration & dosage,  adverse effects*
Liver Neoplasms / therapy*
Pulmonary Embolism / diagnosis,  etiology*,  radiography
Respiratory Distress Syndrome, Adult / diagnosis,  etiology*,  radiography
Retrospective Studies
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 0/Contrast Media; 23214-92-8/Doxorubicin; 8001-40-9/Iodized Oil

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