Duodenal fistula following Port-a-cath - a rare complication of regional hepatic chemotherapy

Arterial port systems are frequently used in the adjuvant and palliative th erapy of colorectal hepatic metastasis. Specific complications are rarely d ocumented in literature. The perforation of an arterial Port-a-cath followe d by duodenal fistula is an uncommon complication of regional hepatic chemo therapy. Besides systemic disorders caused by the chemotherapeutic agents, such as vomiting, sickness, or gastritis and duodenitis, gastroduodenal ulc ers can occur as a local complication of treatment. Thrombosis of the hepat ic artery or occlusion of the port device are the most common reasons for w ithdrawal of treatment in our series. Based on our experience and the case report of a duodenal fistula we recommend angiography of the port system pr ior to each cycle of chemotherapy.