Gas-Forming Pyogenic Liver Abscess Developed after Drug-Eluting Bead Transarterial Chemoembolization Therapy for A Large Hepatocellular Carcinoma: A Case Report and Review of Literature

Liver abscess after hepatic artery embolization is a rare but serious complication associated with significant morbidity and mortality. Here we report a 52-year-old case of chronic hepatitis B, liver cirrhosis and diabetes mellitus (DM) type 2 with a large gas forming liver abscess (11.4 cm) developed after transarterial chemoembolization (TACE) treatment for a large hepatocellular carcinoma (HCC). The condition responded well to four weeks of antibiotics treatment plus percutaneous drainage with continuous abscess regression after treatment. Infection of the necrotic tumor seems to be the cause of abscess formation in this case. We suggest that for patient with large tumor size, multiple risk factors such as DM, liver cirrhosis, associated biliary disease and old age; post TACE abscess formation should be highly aware of, investigated early and treated promptly. Prophylaxis antibiotics may also be considered.