A 77-year-old man who
received transarterial chemoembolization
for large hepatocellular carcinomas complained of acute pain in the
upper abdomen and suddenly developed severe jaundice, anemia, and massive hematuria. Abdominal computed tomography demonstrated
gas gangrene at the tumor site. Clostridium
perfringens was identified from blood samples and drainage cultures from
the liver abscess. Despite intensive treatment, the patient died 55 hours
after chemoembolization due to multiple
organ failure. When treating patients with large tumors, such as in our
case, this rare but fatal complication that causes sepsis and hemolysis with
lightning-like rapidity should be considered.
Cite this paper
Sakamoto, N. , Yamaguchi, M. , Okada, T. , Idoguchi, K. , Ueshima, E. , Muradi, A. and Sugimoto, K. (2012) Fatal liver abscess caused by Clostridium perfringens complicated with transarterial chemoembolization. Journal of Biomedical Science and Engineering, 5, 763-766. doi: 10.4236/jbise.2012.512A095.
 Yamada, R., Sato, M., Kawabata, M., et al. (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology, 148, 397-401．
 Sakamoto, N., Monzawa, S., Nagano, H., et al. (2007) Acute tumor lysis syndrome caused by transcatheter oily chemoembolization in a patient with a large hepatocellular carcinoma. Cardiovascular and Interventional Radiology, 30, 508-511. doi:10.1007/s00270-005-0240-8
 Song, S.Y., Chung, J.W., Han, J.K., et al. (2001) Liver abscess after transcatheter oily chemoembolization for hepatic tumors: Incidence, predisposing factors, and clinical outcome. Journal of Vascular and Interventional Radiology, 12, 313-320. doi:10.1016/S1051-0443(07)61910-1
 van Bunderen, C.C., Bomers, M.K., Wesdorp, E., et al. (2010) Clostridium perfringens septicemia with massive intravascular haemolysis: A case report and review of the literature. Netherlands Journal of Medicine, 68, 343-346.
 Gerson, L.B., Pont, A. and Cummins, R.T. (1994) Clostridial bacteremia and death following chemoembolization for hepatocellular carcinoma. Journal of Vascular and Interventional Radiology, 5, 167-170.
 de Baere, T., Roche, A., Amenabar, J.M., et al. (1996) Liver abscess formation after local treatment of liver tumors. Hepatology, 23, 1436-1440.
 Eckel, F., Lersch, C., Huber, W., et al. (2000) Multimicrobial sepsis including Clostridium perfringens after chemoembolization of a single liver metastasis from common bile duct cancer. Digestion, 62, 208-212.
 Shim, J.H., Park, J.W., Choi, J.I., et al. (2009) Does postembolization fever after chemoembolization have prognostic significance for survival in patients with unresectable hepatocellular carcinoma? Journal of Vascular and Interventional Radiology, 20, 209-216.