ABSTRACT
Transcatheter arterial chemoembolization (TACE) is widely used in the treatment of hepatocellular carcinomas. We report a case of mult iple liver abscess with bile duct necrosis following gallbladder infarction after TACE in a patient with hepatocellular carcinoma. A 62-year old man, wit h four cm sized hepatocellular carcinoma in right lobe, was treat ed by TACE for six times during 18 months. Two days after the last TACE, acute cholecystitis occurred and antibiotics were used until the recovery of cholecystitis. After two months, abdominal CT scan revealed a gas containing liver abscess and percutaneous transhepatic drainage was performed. Cholangiography via drainage cathet er showed findings of bile duct necrosis. Ant ibiotics sensit ive to the causative organism were administered intravenously. However, the abscess persisted despite of treatment for three mont hs.
Subject(s)
Humans , Middle Aged , Abscess , Anti-Bacterial Agents , Ants , Bile Ducts , Bile , Carcinoma, Hepatocellular , Cholangiography , Cholecystitis , Cholecystitis, Acute , Drainage , Fendiline , Gallbladder , Infarction , Liver Abscess , Liver , Necrosis , Tomography, X-Ray ComputedABSTRACT
Vinte e seis pacientes portadores de insuficiencia coronaria cronica fizeram uso isolado de verapamil e fendilina, por prazo de 4 semanas, com 2 semanas intercaladas, de uso de placebo. Realizaram-se controle clinico e eletrocardiografico semanal e teste ergometrico a cada 2 semanas, durante todas as fases do trabalho. No final do prazo de uso de cada substancia, foram feitos: radiografia do torax, hemograma, hemossedimentacao, exame de urina, determinacao da concentracao de glicose, ureia, acido urico lipides, SGOT, SGPT, sodio e potassio no sangue. Foram analisados estatisticamente os resultados. O verapamil revelou eficacia na melhoria dos tracados eletrocardiograficos alterados em 75% dos casos e a fendilina em 58%, havendo 12% de casos em que nenhuma substancia logrou atenuar as alteracoes encontradas. A ocorrencia de efeitos ao uso das drogas foi objeto de analise especial