Hepatic Radioembolization Complicated by Abscess

ABSTRACT

Hepatic abscess is a rare complication of yttrium-90 radioembolization of hepatic tumors that most commonly occurs in patients with a history of biliary intervention. Patients usually present several weeks after therapy with pain, nausea, vomiting, and fever. Cross-sectional imaging is necessary in cases of suspected abscess to ensure prompt diagnosis and to help plan treatment, which involves antibiotics and percutaneous drainage.

Radioembolization - infection - abscess - embolization

REFERENCES

• 1 Atassi B, Bangash A K, Lewandowski R J et al.. Biliary sequelae following radioembolization with yttrium-90 microspheres.  J Vasc Interv Radiol. 2008;  19 (5) 691-697
• 2 Mascarenhas N B, Mulcahy M F, Lewandowski R J, Salem R, Ryu R K. Hepatic abscess after yttrium-90 radioembolization for islet-cell tumor hepatic metastasis.  Cardiovasc Intervent Radiol. 2010;  33 (3) 650-653
• 3 Kim W, Clark TWI, Baum R A, Soulen M C. Risk factors for liver abscess formation after hepatic chemoembolization.  J Vasc Interv Radiol. 2001;  12 (8) 965-968
• 4 Song S Y, Chung J W, Han J K et al.. Liver abscess after transcatheter oily chemoembolization for hepatic tumors: incidence, predisposing factors, and clinical outcome.  J Vasc Interv Radiol. 2001;  12 (3) 313-320
• 5 Xia J, Ren Z, Ye S et al.. Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer.  Eur J Radiol. 2006;  59 (3) 407-412
• 6 Tarazov P G, Polysalov V N, Prozorovskij K V, Grishchenkova I V, Rozengauz E V. Ischemic complications of transcatheter arterial chemoembolization in liver malignancies.  Acta Radiol. 2000;  41 (2) 156-160
• 7 Kim M H, Choi M S, Choi Y S et al.. Clinical features of liver abscess developed after radiofrequency ablation and transarterial chemoembolization for hepatocellular carcinoma.  Korean J Hepatol. 2006;  12 (1) 55-64
• 8 Chung J W, Park J H, Han J K et al.. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization.  Radiology. 1996;  198 (1) 33-40
• 9 Georgiades C S, Hong K, Geschwind J F. Pre- and postoperative clinical care of patients undergoing interventional oncology procedures: a comprehensive approach to preventing and mitigating complications.  Tech Vasc Interv Radiol. 2006;  9 (3) 113-124
• 10 Salem R, Thurston K G. Radioembolization with 90yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 2: special topics.  J Vasc Interv Radiol. 2006;  17 (9) 1425-1439
• 11 Chen C, Chen P J, Yang P M et al.. Clinical and microbiological features of liver abscess after transarterial embolization for hepatocellular carcinoma.  Am J Gastroenterol. 1997;  92 (12) 2257-2259
• 12 Atassi B, Bangash A K, Bahrani A et al.. Multimodality imaging following 90Y radioembolization: a comprehensive review and pictorial essay.  Radiographics. 2008;  28 (1) 81-99
• 13 Akahane M, Koga H, Kato N et al.. Complications of percutaneous radiofrequency ablation for hepato-cellular carcinoma: imaging spectrum and management.  Radiographics. 2005;  25 (Suppl 1) S57-S68
• 14 Lim H K, Choi D, Lee W J et al.. Hepatocellular carcinoma treated with percutaneous radio-frequency ablation: evaluation with follow-up multiphase helical CT.  Radiology. 2001;  221 (2) 447-454
• 15 Johannsen E C, Sifri C D, Madoff L C. Pyogenic liver abscesses.  Infect Dis Clin North Am. 2000;  14 (3) 547-563, vii
• 16 de Baère T, Roche A, Amenabar J M et al.. Liver abscess formation after local treatment of liver tumors.  Hepatology. 1996;  23 (6) 1436-1440