Fatal liver abscess caused by Clostridium perfringens complicated with transarterial chemoembolization

A 77-year-old man who received transarterial chemo- embolization for large hepatocellular carcinomas com- plained of acute pain in the upper abdomen and sud- denly developed severe jaundice, anemia, and massive hematuria. Abdominal computed tomography demon- strated gas gangrene at the tumor site. Clostridium perfringens was identified from blood samples and drainage cultures from the liver abscess. Despite in- tensive treatment, the patient died 55 hours after chemoembolization due to multiple organ failure. When treating patients with large tumors, such as in our case, this rare but fatal complication that causes sep- sis and hemolysis with lightning-like rapidity should be considered. Keywords: Liver; Hepatocellular Carcinoma; Transarterial Chemoembolization; Clostridium perfringens