Published online Apr 14, 2015. doi: 10.3748/wjg.v21.i14.4397
Peer-review started: September 18, 2014
First decision: December 2, 2014
Revised: January 28, 2015
Accepted: March 19, 2015
Article in press: March 19, 2015
Published online: April 14, 2015
We report an unusual case of Clostridium perfringens liver abscess formation after transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma. Severe deterioration in liver and renal function accompanied with hemocytolysis was found on the 2nd day after TACE. Blood culture found Clostridium perfringens and abdominal computed tomography revealed a gas-containing abscess in the liver. Following antibiotics administration and support care, the infection was controlled and the liver and renal function turned normal. The 2nd TACE procedure was performed 1.5 mo later and no recurrent Clostridium perfringens infection was found.
Core tip: Transcatheter arterial chemoembolization (TACE) is a major treatment for patients with hepatocellular carcinoma (HCC) that is not eligible for curative treatment. Though rare, Clostridium perfringens liver abscess after TACE is fatal. We successfully treated a 71-year-old man with large HCC who had liver and renal dysfunction and developed Clostridium perfringens liver abscess after TACE. After timely identification of the patient’s deteriorating condition, aggressive treatments, including antibiotics administration, anticoagulation and intensive care, were provided.