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CASE REPORTS  
CMH 2012 September;18:321-325.
Published online 2012 September 26. doi:http://dx.doi.org/10.3350/cmh.2012.18.3.321
Copyright © 2012 The Korean Association for the Study of the Liver
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A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma
Song-I Bae1, Jong Eun Yeon1, Jong Mee Lee2, Ji Hoon Kim1, Hyun Jung Lee1, Sun Jae Lee1, Sang Jun Suh1, Eileen L. Yoon1, Hae Rim Kim1, Kwan Soo Byun1, Tae-Seok Seo2
1Department of Internal Medicine and 2Department of Radiology, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Jong Eun Yeon ,Tel: +82-2-2626-3010, Fax: +82-2-2626-1038, Email: je_yeon@hotmail.com
ABSTRACT
Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.
Keywords: Carcinoma, Hepatocellular; Therapeutic chemoembolization; Acute necrotizing pancreatitis
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