Emphysematous cholecystitis: complication of hepatic artery embolization

Area of Science:

• Gastroenterology and Hepatology
• Interventional Radiology

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy.
• Hepatic artery embolization (HAE) is a common treatment for unresectable HCC.
• Emphysematous cholecystitis (EC) is a rare, severe infection of the gallbladder.

Observation:

• A case of acute emphysematous cholecystitis developed after HAE for HCC.
• The patient's condition improved with conservative management, including antibiotics and supportive care.
• No surgical intervention was required for the EC.

Findings:

• EC is a potential, albeit uncommon, complication following HAE.
• The pathogenesis of EC in this context may be linked to the embolization procedure.
• Conservative therapy can be effective in managing EC post-HAE.

Implications:

• Clinicians should consider EC in patients presenting with abdominal symptoms after HAE.
• Early recognition and conservative treatment may prevent the need for cholecystectomy.
• Further research is warranted to elucidate the precise mechanisms linking HAE and EC.