Can ethanol therapies injure the bile ducts?

Administration of ethanol, whether applied directly to tissue or via an intra-arterial route, has been widely used to treat a variety of hepatic disorders, most importantly hepatocellular carcinoma. Animal studies, however, have demonstrated that intravascular hepatic ethanol therapy causes significant bile duct injury, and therefore, many centers have used intravascular ethanol applications with caution. A case of extensive bile duct injury in a 35-year-old female with a symptomatic hepatic hemangioma treated with ethanol embolization is presented. Although a seemingly rare complication, the possibility of bile duct injury should be considered prior to planned ethanol liver treatment, and a high index of suspicion should be maintained should signs of hepatic dysfunction subsequently arise.