Fatal bile pulmonary embolism after radiofrequency treatment of a hepatocellular carcinoma.

Abstract

Radiofrequency is increasingly used to manage liver tumors. This report describes the case of a 74-year-old man who received two courses of percutaneous radiofrequency thermal ablation for a hepatocellular carcinoma over a 4-month period. He subsequently required computed tomography-guided drainage for an area of intrahepatic necrosis. During the procedure, hemobilia developed, followed by respiratory distress and collapse. The diagnosis of bile pulmonary embolism was established on the basis of high biliary acid concentrations in pulmonary fluid aspiration and blood plasma. Radiofrequency thermoablation provides local control of advanced liver tumors with low recurrence and morbidity. However, this interventional procedure risks damage to liver parenchyma involving vascular and biliary structures, which may lead to biliary-venous fistula and possible bile emboli.

AI evidence extraction

Main findings

A 74-year-old man underwent two courses of percutaneous radiofrequency thermal ablation for hepatocellular carcinoma and later developed hemobilia during CT-guided drainage, followed by respiratory distress and collapse. Bile pulmonary embolism was diagnosed based on high biliary acid concentrations in pulmonary fluid aspiration and blood plasma; the report notes potential for biliary-venous fistula and bile emboli after the procedure.

Outcomes measured

• Bile pulmonary embolism
• Hemobilia
• Respiratory distress and collapse
• Intrahepatic necrosis requiring CT-guided drainage

Limitations

• Single-patient case report
• No radiofrequency exposure parameters (e.g., frequency, power, SAR) reported
• Findings may not be generalizable

Suggested hubs

• other (0.2)
  Medical radiofrequency ablation complication; not an environmental/telecom EMF exposure study.

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency thermal ablation (medical procedure)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": "two courses over a 4-month period"
    },
    "population": "74-year-old man with hepatocellular carcinoma",
    "sample_size": 1,
    "outcomes": [
        "Bile pulmonary embolism",
        "Hemobilia",
        "Respiratory distress and collapse",
        "Intrahepatic necrosis requiring CT-guided drainage"
    ],
    "main_findings": "A 74-year-old man underwent two courses of percutaneous radiofrequency thermal ablation for hepatocellular carcinoma and later developed hemobilia during CT-guided drainage, followed by respiratory distress and collapse. Bile pulmonary embolism was diagnosed based on high biliary acid concentrations in pulmonary fluid aspiration and blood plasma; the report notes potential for biliary-venous fistula and bile emboli after the procedure.",
    "effect_direction": "harm",
    "limitations": [
        "Single-patient case report",
        "No radiofrequency exposure parameters (e.g., frequency, power, SAR) reported",
        "Findings may not be generalizable"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency",
        "thermal ablation",
        "hepatocellular carcinoma",
        "bile pulmonary embolism",
        "hemobilia",
        "biliary-venous fistula",
        "interventional complication"
    ],
    "suggested_hubs": [
        {
            "slug": "other",
            "weight": 0.200000000000000011102230246251565404236316680908203125,
            "reason": "Medical radiofrequency ablation complication; not an environmental/telecom EMF exposure study."
        }
    ]
}

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