Document Detail

Fatal bile pulmonary embolism after radiofrequency treatment of a hepatocellular carcinoma.
MedLine Citation:
PMID:  14973755     Owner:  NLM     Status:  MEDLINE    
Radiofrequency is increasingly used to manage liver tumors. This report describes the case of a 74-year-old man who received two courses of percutaneous radiofrequency thermal ablation for a hepatocellular carcinoma over a 4-month period. He subsequently required computed tomography-guided drainage for an area of intrahepatic necrosis. During the procedure, hemobilia developed, followed by respiratory distress and collapse. The diagnosis of bile pulmonary embolism was established on the basis of high biliary acid concentrations in pulmonary fluid aspiration and blood plasma. Radiofrequency thermoablation provides local control of advanced liver tumors with low recurrence and morbidity. However, this interventional procedure risks damage to liver parenchyma involving vascular and biliary structures, which may lead to biliary-venous fistula and possible bile emboli.
C Schmidt-Mutter; T Breining; A Gangi; E Canela; I Jourdan; D Mutter; J-P Dupeyron
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2003-10-28
Journal Detail:
Title:  Surgical endoscopy     Volume:  17     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-19     Completed Date:  2004-07-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2028-31     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, Hôpital Civil, Hôpitaux Universitaires, 1 Place de l'Hôpital, 67091 Strasbourg Cedex, France.
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MeSH Terms
Anuria / etiology
Bile Ducts, Intrahepatic / injuries*,  radiography
Biliary Fistula / etiology
Carcinoma, Hepatocellular / complications,  surgery*
Catheter Ablation / adverse effects*
Drainage / adverse effects
Fatal Outcome
Hemobilia / etiology
Intraoperative Complications / etiology
Liver / injuries,  radiography
Liver Neoplasms / complications,  surgery*
Postoperative Complications / etiology
Pulmonary Embolism / etiology*
Punctures / adverse effects*
Radiography, Interventional
Respiratory Distress Syndrome, Adult / etiology
Tomography, X-Ray Computed
Vascular Fistula / etiology

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