Clear Visualization of Extravasation on Angiography Using Carbon Dioxide in a Case of Hepatocellular Carcinoma Rupture with Unclear Visualization Using Iodine Contrast Agent

Hironori Ochi; Masashi Hirooka; Yohei Koizumi; Fujimasa Tada; Takao Watanabe; Yoshio Tokumoto; Hiroaki Tanaka; Teruhito Mochizuki; Masanori Abe; Yoichi Hiasa

doi:10.2169/internalmedicine.54.3144

CASE REPORTS

Clear Visualization of Extravasation on Angiography Using Carbon Dioxide in a Case of Hepatocellular Carcinoma Rupture with Unclear Visualization Using Iodine Contrast Agent

Hironori Ochi, Masashi Hirooka, Yohei Koizumi, Fujimasa Tada, Takao Watanabe, Yoshio Tokumoto, Hiroaki Tanaka, Teruhito Mochizuki, Masanori Abe, Yoichi Hiasa

Author information

Hironori Ochi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Masashi Hirooka
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Yohei Koizumi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Fujimasa Tada
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Takao Watanabe
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Yoshio Tokumoto
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Hiroaki Tanaka
Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Japan
Teruhito Mochizuki
Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Japan
Masanori Abe
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
Yoichi Hiasa
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan

Keywords: hepatocellular carcinoma, carbon dioxide, angiography, therapeutic embolization, rupture, bleeding

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 4 Pages 407-410

DOI https://doi.org/10.2169/internalmedicine.54.3144

Details

Abstract

A 62-year-old woman with hepatocellular carcinoma (HCC) and asthma presented with acute abdominal pain and a decreased hemoglobin level. Peritoneal fluid was detected around the lesion, and rupture was suspected based on the findings of computed tomography. Extravasation of the HCC tumor was not detected on angiography with iodine contrast agent; however, such extravasation was clearly observed on angiography with carbon dioxide (CO₂). CO₂ angiography is sometimes utilized in patients with arterial bleeding. This modality be more effective and safe than angiography with iodine contrast agent for assessing potential ruptured HCC lesions.

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