2007 Volume 48 Issue 12 Pages 610-615
A 58-year-old man, diagnosed with hepatocellular carcinoma (HCC) when he was 55 years old and having been treated by a hepatic arterial infusion chemotherapy (HAIC) for one year, was admitted to our hospital for the 6th course of HAIC; but this time he was suffering from tarry stool. Gastrointestinal endoscopy showed the existence of blood clot out of papilla of Vater, and abdominal CT demonstrated infiltration of HCC in right biliary tract, leading to the diagnosis of hemobilia associated with biliary tract infiltration of HCC. Tumor stain in the location consistent with right biliary tract was demonstrated on abdominal angiography. Transcatheter arterial embolization (TAE) was carried out with a result of disappearance of hemobilia. Despite additional 2 courses of HAIC, he died of hepatic failure 7 months later. Based on 41 cases so far reported in Japan, prognosis of HCC complicated with hemobilia is poor. Nevertheless, our present case suggests that TAE is effective for stopping hemobilia, and may thus enable continuing chemotherapy thereafter.
