華山論劍-專業案例挑戰/Case 2015-008

Date: 30 Sep. posted by 徐銘宏/曾政豪/張吉仰醫師 Revised: 陳志城醫師學術天地

Answer of Case 2015-008

CLINIC COURSE:

he second look EGD found foreign body in duodenal ulcer (Figure 1) which suspected previous Transcatheter Arterial Embolization related.

Coil embolization is commonly performed into the right gastric artery (RGA) or gastroduodenal artery (GDA) before HAIC to avoid unfavorable influx of anticancer agents into non-target organs. This patient ever received coil embolization into GDA at previous TACE (Figure 2). However, complications of coil embolization include intra-procedural rupture or dissection of target vessels, thromboembolic events, infections, and coil migration. But, there is no definite management of coil migration.

Figure 1.

Figure 2.

Final Diagnosis:

Duodenal ulcer bleeding, coil migration related.