Severe gangrene of the stomach and infarction of the liver and spleen after percutaneous ethanol injection for hepatocellular carcinoma

Report of a case

Kuo Chih Tseng, Shao Jer Chen, An Liang Chou, Jeh En Tzeng, Hong-Ming Tsai, Pin-Nan Cheng

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Percutaneous ethanol injection is a safe and effective treatment for small hepatocellular carcinoma. The complication rate is lower in the injury of liver, stomach and spleen. We herein report an 82-year-old female with chronic hepatitis C-related hepatocellular carcinoma, measuring 4.0 × 2.8 cm in the left lobe of liver. Because of high risk of surgery, she received percutaneous ethanol injection in segmental fractions with 1-2 cc in one fraction, total 20 milliliter of 95% ethanol in one session, and then soon suffered complications of gangrene of the stomach and infarction of the liver and spleen. Although surgical intervention and intensive care were administrated, she finally died of sepsis with multiple organ failure. The mechanism of percutaneous ethanol injection-related injuries to a combination of stomach, liver and spleen is probably vascular injury by ethanol. It is recommended that a slower injection speed, small amounts of ethanol during procedure and assessment of vascular anatomy before percutaneous ethanol injection are needed to avoid such severe ethanol-induced vessel injury.

Original languageEnglish
Pages (from-to)33-38
Number of pages6
JournalJournal of Internal Medicine of Taiwan
Volume17
Issue number1
Publication statusPublished - 2006 Feb 1

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Gangrene
Infarction
Hepatocellular Carcinoma
Stomach
Ethanol
Spleen
Injections
Liver
Wounds and Injuries
Multiple Organ Failure
Vascular System Injuries
Chronic Hepatitis C
Critical Care
Blood Vessels
Anatomy
Sepsis

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

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abstract = "Percutaneous ethanol injection is a safe and effective treatment for small hepatocellular carcinoma. The complication rate is lower in the injury of liver, stomach and spleen. We herein report an 82-year-old female with chronic hepatitis C-related hepatocellular carcinoma, measuring 4.0 × 2.8 cm in the left lobe of liver. Because of high risk of surgery, she received percutaneous ethanol injection in segmental fractions with 1-2 cc in one fraction, total 20 milliliter of 95{\%} ethanol in one session, and then soon suffered complications of gangrene of the stomach and infarction of the liver and spleen. Although surgical intervention and intensive care were administrated, she finally died of sepsis with multiple organ failure. The mechanism of percutaneous ethanol injection-related injuries to a combination of stomach, liver and spleen is probably vascular injury by ethanol. It is recommended that a slower injection speed, small amounts of ethanol during procedure and assessment of vascular anatomy before percutaneous ethanol injection are needed to avoid such severe ethanol-induced vessel injury.",
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Severe gangrene of the stomach and infarction of the liver and spleen after percutaneous ethanol injection for hepatocellular carcinoma : Report of a case. / Tseng, Kuo Chih; Chen, Shao Jer; Chou, An Liang; Tzeng, Jeh En; Tsai, Hong-Ming; Cheng, Pin-Nan.

In: Journal of Internal Medicine of Taiwan, Vol. 17, No. 1, 01.02.2006, p. 33-38.

Research output: Contribution to journalArticle

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AB - Percutaneous ethanol injection is a safe and effective treatment for small hepatocellular carcinoma. The complication rate is lower in the injury of liver, stomach and spleen. We herein report an 82-year-old female with chronic hepatitis C-related hepatocellular carcinoma, measuring 4.0 × 2.8 cm in the left lobe of liver. Because of high risk of surgery, she received percutaneous ethanol injection in segmental fractions with 1-2 cc in one fraction, total 20 milliliter of 95% ethanol in one session, and then soon suffered complications of gangrene of the stomach and infarction of the liver and spleen. Although surgical intervention and intensive care were administrated, she finally died of sepsis with multiple organ failure. The mechanism of percutaneous ethanol injection-related injuries to a combination of stomach, liver and spleen is probably vascular injury by ethanol. It is recommended that a slower injection speed, small amounts of ethanol during procedure and assessment of vascular anatomy before percutaneous ethanol injection are needed to avoid such severe ethanol-induced vessel injury.

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