IODIZED OIL IN THE PORTAL-VEIN AFTER ARTERIAL CHEMOEMBOLIZATION OF LIVER METASTASES - A CAUTION REGARDING HEPATIC-NECROSIS

Of 20 patients with hepatic metastases from colorectal cancer treated by arterial chemoembolization, 4 showed iodized oil in peripheral bran ches of the portal vein. Aseptic necrosis of both the tumor and normal parenchyma in corresponding liver segments developed in 2 of these pa tients. They were successfully treated with antibiotics and percutaneo us drainage. In the 2 remaining patients, the procedure was interrupte d before complete arterial occlusion when oil was detected in the port al vein on fluoroscopy, and there was no complication. Appearance of i odized oil in the portal vein during arterial chemoembolization of col orectal liver metastases is an unfavorable event signaling the risk of liver necrosis.