Liver perforation: A serious complication of percutaneous acetic acid injection for hepatocellular carcinoma

A 75-year-old cirrhotic man, after undergoing percutaneous acetic acid inje ction therapy for hepatocellular carcinoma, presented high fever and right hypochondralgia. Computed tomography disclosed an area of low attenuation i n the liver and a crescent-shaped intraperitoneal lesion adjacent to it. We diagnosed liver perforation and localized peritonitis due to the leakage o f acetic acid following acetic acid injection. It is important to consider this serious complication when evaluating the indications for percutaneous acetic acid injection for hepatocellular carcinoma.