A case of biliary gastric fistula following percutaneous radiofrequency thermal ablation of hepatocellular carcinoma.

Percutaneous radiofrequency thermal ablation (RFA) is an effective and safe therapeutic modality in the management of liver malignancies, performed with ultrasound guidance. Potential complications of RFA include liver abscess, ascites, pleural effusion, skin burn, hypoxemia, pneumothorax, subcapsular hematoma, hemoperitoneum, liver failure, tumour seeding, biliary lesions. Here we describe for the first time a case of biliary gastric fistula occurred in a 66-year old man with a Child's class A alcoholic liver cirrhosis as a complication of RFA of a large hepatocellular carcinoma lesion in the III segment.

[Assessment of the therapeutic effectiveness of alcohol administration in hepatocarcinoma: comparison of spiral computerized tomography and Doppler color ultrasonography].

Purpose: To investigate the comparative adequacy of spiral CT and color-Doppler US versus biopsy in assessing the efficacy of percutaneous ethanol injection (PEI) in hepatocellular carcinoma (HCC).

Materials And Methods: Fifteen patients with 30 known HCCs, 2-5 cm in diameter, underwent PEI. Arterial phase spiral CT and color-Doppler US were performed before treatment in all patients.

[Hyponatremia in cirrhosis with ascites].

Hyponatremia complicates ascitic hepatic cirrhosis with frequency and gravity related to the gravity of the cirrhosis itself. When hyponatremia develops, it worsens the already present secondary hyperaldosteronism and makes therapy with spironolactone inefficacious. From a pathophysiologic viewpoint a pathogenetic role in determining hyponatremia is attributable to the reduced plasmatic renal perfusion; in several patients a syndrome of inappropriate ADH secretion develops.