Diaphragmatic perforation after transcatheter arterial chemoembolization of hepatocellular carcinoma via inferior phrenic artery: a case report

BMC Gastroenterology

Suk Hyun Bae¹  Ji Soo Kim²  Woong Hee Lee²  Hyoung Nam Lee² 

[1] Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea;Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea;

关键词: Embolization, Therapeutic;    Hernia, Diaphragmatic;    Multidetector Computed Tomography;    Carcinoma, Hepatocellular;    Case Reports;   

DOI  :  10.1186/s12876-022-02110-6

来源: Springer

【 摘 要 】

BackgroundTranscatheter arterial chemoembolization (TACE) via the inferior phrenic artery has been recognized to have its own therapeutic role without causing serious procedural complications. We report a case of diaphragmatic perforation after repeated TACE sessions conducted via the right inferior phrenic artery.Case presentationA 43-year-old man diagnosed with hepatocellular carcinoma was admitted to the hospital with a chief complaint of cough. The patient underwent TACE via the right inferior phrenic artery 3 months prior and was discharged without specific complications. Physical examination revealed decreased breathing sounds in the right lower lung zone. Chest radiograph demonstrated a small right pleural effusion. Chest CT scan revealed a small diaphragmatic perforation. The patient was unable to undergo surgical exploration, and a follow-up CT scan after 2 months revealed progression of the right diaphragmatic perforation with massive herniation of omental fat into the thoracic cavity.ConclusionsAlthough TACE via the inferior phrenic artery is a relatively safe procedure, it can be associated with rare but serious complications after repeated procedures. This is a rare case report of diaphragmatic perforation after TACE via the right inferior phrenic artery. Early recognition and prompt surgical management are essential to prevent catastrophic outcomes.

【 授权许可】

CC BY