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Case Report

Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report

Yun Won Jo, Jeong-Mi Lee, Ja Yoon Choi, Dong-Hoon Lew, Ra Ri Cha, Hye Won Oh, Hong-Jun Kim, Hyun Ju Min, Hyun Jin Kim, Woon-Tae Jung, Ok-Jae Lee, Chang Yoon Ha, Sun Young Yi1
The Ewha Medical Journal 2013;36(1):62-66. Published online: March 25, 2013

Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.

1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 660-702, Korea. Tel: 82-55-750-8057, Fax: 82-55-758-9122, singrum@daum.net
• Received: September 3, 2012   • Accepted: October 8, 2012

Copyright © 2013. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.
  • Keywords: Acute respiratory distress syndrome; Chemoembolization; Hepatocellular carcinoma
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Fig. 1
Abdomen computed tomography showes huge hepatocellular carcinoma involving right hepatic lobe.
emj-36-62-g001.jpg
Fig. 2
Common hepatic artery angiography showes huge hypervascular tumor staining in right hepatic lobe.
emj-36-62-g002.jpg
Fig. 3
(A) Initial chest x-ray shows reticular opacity in both lower lobes. (B) chest x-ray after TACE shows transcatheter arterial chemoembolization (TACE) multifocal bilateral patchy ground glass opacity.
emj-36-62-g003.jpg
Fig. 4
Chest computed tomography shows multifocal crazy paving pattern and interlobular septal thickening in both lung, and honeycombing in both lower lobes.
emj-36-62-g004.jpg

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      Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report
      Ewha Med J. 2013;36(1):62-66.   Published online March 25, 2013
      DOI: https://doi.org/10.12771/emj.2013.36.1.62
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      Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report
      Ewha Med J. 2013;36(1):62-66.   Published online March 25, 2013
      DOI: https://doi.org/10.12771/emj.2013.36.1.62
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      Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report
      Image Image Image Image
      Fig. 1 Abdomen computed tomography showes huge hepatocellular carcinoma involving right hepatic lobe.
      Fig. 2 Common hepatic artery angiography showes huge hypervascular tumor staining in right hepatic lobe.
      Fig. 3 (A) Initial chest x-ray shows reticular opacity in both lower lobes. (B) chest x-ray after TACE shows transcatheter arterial chemoembolization (TACE) multifocal bilateral patchy ground glass opacity.
      Fig. 4 Chest computed tomography shows multifocal crazy paving pattern and interlobular septal thickening in both lung, and honeycombing in both lower lobes.

      Fig. 1

      Fig. 2

      Fig. 3

      Fig. 4

      Acute Respiratory Distress Syndrome after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report
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