Epirubicin/ethiodized oil
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Obstructive jaundice and acute pancreatitis following chemoembolisation in an elderly patient: case report A 69-year-old man developed obstructive jaundice and acute pancreatitis following chemoembolisation of liver tumours with epirubicin and ethiodized oil. The man had a history of hepatitis C-related cirrhosis and liver cancer, and had previously undergone transcatheter chemoembolisation and radiofrequency ablation. Two new liver tumours, one in the medial segment and another in the lateral segment, developed and transcatheter chemoembolisation was performed; epirubicin 12mg and ethiodized oil [Lipiodol] 1.2mL were injected into the arteries supplying the medial tumour, and epirubicin 8mg and ethiodized oil 0.8mL were administered to treat the lateral tumour. Gelatin sponge particles were also administered. He was discharged on postoperative day 10, but was readmitted 8 days later with jaundice and severe back pain. Laboratory investigations revealed a serum amylase level of 1000 IU/L and a total bilirubin level of 8.03 mg/dL. A CT scan showed dilation of the intrahepatic and common bile ducts and a high-density deposit at the bottom of the common bile duct, thought to be sloughed tumour with ethiodized oil accumulation. Endoscopy revealed sloughed tumour obstructing the ampulla of vater and protruding into the lumen of the duodenum. The man underwent endoscopic sphincterotomy, after which his back pain resolved. His serum amylase level normalised 2 days later and his bilirubin level normalised after 1 month. Hiraki T, et al. Sloughing of intraductal tumor thrombus of hepatocellular carcinoma after transcatheter chemoembolization causing obstructive jaundice and acute pancreatitis. Journal of Vascular and Interventional Radiology 17: 583-585, 801066940 No. 3, Mar 2006 - Japan
0114-9954/10/1110-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Jul 2006 No. 1110
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