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"María del Mar Díaz Alcázar, Alicia Martín-Lagos Maldonado, Elena Ruiz Escolano" "autores" => array:3 [ 0 => array:4 [ "nombre" => "María del Mar" "apellidos" => "Díaz Alcázar" "email" => array:1 [ 0 => "mmardiazalcazar@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alicia" "apellidos" => "Martín-Lagos Maldonado" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Ruiz Escolano" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica del Aparato Digestivo, Hospital Universitario Clínico San Cecilio, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Complicación infrecuente tras quimioembolización de hepatocarcinoma sobre hígado cirrótico: absceso hepático y pileflebitis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 731 "Ancho" => 905 "Tamanyo" => 98560 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional view of abdominal computed tomography with intravenous contrast showing thrombosis of the right portal vein compatible with pylephlebitis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 74-year-old male with hepatocellular carcinoma in segment 6 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) with underlying alcoholic cirrhosis, Child-Pugh B8, treated with transarterial chemoembolisation (TACE). Five days later, he developed pain in the right hypochondriac region, without fever. Abdominal computed tomography scan showed an abscessed lesion 60 × 100 × 60 mm in size in segment 6, extending to the perihepatic space, with a collection 160 × 22 × 135 mm in size and pylephlebitis (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). This was treated with intravenous meropenem and ultrasound-guided percutaneous drainage with catheter placement. Subsequent scans showed the collection decreasing in size (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">TACE is the treatment of choice in Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma, and is also effective in unresectable liver metastases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> It is minimally invasive, but it can have serious complications such as liver abscesses.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4</span></a> These are rare, with an incidence of 0.2–5%, but have high morbidity and mortality rates.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2,4</span></a> Risk factors are biliary disorders (sphincterotomy or biliary anastomosis), advanced age, diabetes, a large tumour and portal thrombosis.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4</span></a> Sphincter of Oddi dysfunction has been suggested as a pathogenic mechanism, as it would allow bacteria to access the hepatic circulation, infecting necrotic tissue.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The clinical context is important for differentiating between an abscess and the presence of gas in the embolised lesion due to necrosis a few days after embolisation. Moreover, unlike post-embolisation syndrome, which usually occurs early, abscesses may appear more than a week later.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Díaz Alcázar MdM, et al. Complicación infrecuente tras quimioembolización de hepatocarcinoma sobre hígado cirrótico: absceso hepático y pileflebitis. Gastroenterol Hepatol. 2021;44:382–383.</p>" ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 716 "Ancho" => 902 "Tamanyo" => 78627 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional view of abdominal computed tomography with intravenous contrast showing a space-occupying lesion 40 × 30 mm in size in liver segment 6 compatible with hepatocellular carcinoma.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 692 "Ancho" => 905 "Tamanyo" => 83351 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional view of abdominal computed tomography with intravenous contrast showing an abscessed lesion in liver segment 6 with air bubbles in its interior.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 892 "Ancho" => 905 "Tamanyo" => 114377 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Coronal section of abdominal computed tomography with intravenous contrast showing an abscessed lesion extending to the perihepatic space, from right subphrenic to right subhepatic spaces, with air inside.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 731 "Ancho" => 905 "Tamanyo" => 98560 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional view of abdominal computed tomography with intravenous contrast showing thrombosis of the right portal vein compatible with pylephlebitis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Liver abscess formation following transarterial chemoembolization: clinical features, risk factors, bacteria spectrum, and percutaneous catheter drainage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.F. Lv" 1 => "D. Lu" 2 => "Y.S. He" 3 => "J.K. Xiao" 4 => "C.Z. Zhou" 5 => "D.L. Cheng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0000000000003503" "Revista" => array:3 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2016" "volumen" => "95" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case series of liver abscess formation after transcatheter arterial chemoembolization for hepatic tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W. Sun" 1 => "F. Xu" 2 => "X. Li" 3 => "C.R. 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Unusual complication after chemoembolisation of hepatocellular carcinoma over liver cirrhosis: Liver abscess and pylephlebitis
Complicación infrecuente tras quimioembolización de hepatocarcinoma sobre hígado cirrótico: absceso hepático y pileflebitis
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María del Mar Díaz Alcázar
, Alicia Martín-Lagos Maldonado, Elena Ruiz Escolano
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Unidad de Gestión Clínica del Aparato Digestivo, Hospital Universitario Clínico San Cecilio, Granada, Spain
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