GAS-FORMING LIVER-ABSCESS FOLLOWING TRANSCATHETER HEPATIC ARTERIAL EMBOLIZATION FOR AN IATROGENIC INTRAHEPATIC PSEUDOANEURYSM - REPORT OF ACASE

We herein describe a case of a gas-forming pyogenic liver abscess foll owing transcatheter hepatic arterial embolization (THAE) for an iatrog enic intrahepatic pseudoaneurysm in a 74-year-old woman. Hemobilia dev eloped 19 days after percutaneous transhepatic cholangio-dramage was p erformed for the purpose of percutaneous cholangioscopic lithotripsy f or the treatment of post-gastrectomy choledocholithiasis. Celiac arter iography disclosed a saccular aneurysm in the right hepatic artery. Th e pseudoaneurysm was successfully occluded by THAE with gelatin powder and a stainless steel coil of the Gianturco type. Ten days after succ essful THAE, abdominal computed tomography revealed a gas-containing c avity, which suggested the presence of a gas-forming abscess, in the p osterior hepatic segment, and percutaneous transhepatic abscess draina ge was performed. Thus, impaired hepatic perfusion following effective THAE and coexisting cholangitis may play an important role in the dev elopment of a gas-forming pyogenic liver abscess.