Case Report: Rapidly fatal hepatic portal venous gas following transarterial chemoembolization for hepatocellular carcinoma
- 1Department of Intervention, Linyi People’s Hospital
Abstract
Hepatic portal venous gas (HPVG) is an uncommon radiological sign whose clinical importance depends on the underlying disorder and the patient’s physiological state. Only two cases of HPVG following transarterial chemoembolization (TACE) have been reported. We describe a rapidly fatal episode in a 71-year-old man with chronic hepatitis B and biopsy-confirmed hepatocellular carcinoma. Selective TACE involved lobaplatin infusion, followed by 10 mL of an iodized oil-raltitrexed emulsion and 1 mL of epirubicin-loaded drug-eluting microspheres. Constipation and abdominal distension developed approximately 21 h after TACE. Severe abdominal pain and vomiting followed at 37 h. Emergency CT at approximately 38 h showed peripheral branching HPVG, bowel dilatation, and intraluminal fluid. At approximately 39 h, the patient developed impaired consciousness, hypotension, and bradycardia. He died despite resuscitative treatment approximately 40 h after TACE. Lactate, a repeat leukocyte count, blood cultures, and other microbiological samples were not obtained after the acute deterioration. Sepsis therefore remained an unconfirmed possible mechanism. The combined embolization regimen represents a procedural exposure, not a proven cause. Progressive abdominal symptoms after TACE should prompt urgent evaluation for bowel injury, infection, biliary complications, and circulatory deterioration.
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BibTeX
@article{zhao2026case,
title = {{Case Report: Rapidly fatal hepatic portal venous gas following transarterial chemoembolization for hepatocellular carcinoma}},
author = {Renshan Zhao and Bin Xie},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1951000},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1951000/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Rapidly fatal hepatic portal venous gas following transarterial chemoembolization for hepatocellular carcinoma
AU - Renshan Zhao
AU - Bin Xie
PY - 2026
DA - 2026/10/19
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1951000
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1951000/full
AB - Hepatic portal venous gas (HPVG) is an uncommon radiological sign whose clinical importance depends on the underlying disorder and the patient’s physiological state. Only two cases of HPVG following transarterial chemoembolization (TACE) have been reported. We describe a rapidly fatal episode in a 71-year-old man with chronic hepatitis B and biopsy-confirmed hepatocellular carcinoma. Selective TACE involved lobaplatin infusion, followed by 10 mL of an iodized oil-raltitrexed emulsion and 1 mL of epirubicin-loaded drug-eluting microspheres. Constipation and abdominal distension developed approximately 21 h after TACE. Severe abdominal pain and vomiting followed at 37 h. Emergency CT at approximately 38 h showed peripheral branching HPVG, bowel dilatation, and intraluminal fluid. At approximately 39 h, the patient developed impaired consciousness, hypotension, and bradycardia. He died despite resuscitative treatment approximately 40 h after TACE. Lactate, a repeat leukocyte count, blood cultures, and other microbiological samples were not obtained after the acute deterioration. Sepsis therefore remained an unconfirmed possible mechanism. The combined embolization regimen represents a procedural exposure, not a proven cause. Progressive abdominal symptoms after TACE should prompt urgent evaluation for bowel injury, infection, biliary complications, and circulatory deterioration.
SN - 2234-943X
ER -