Massive abdominal hemorrhage after radiofrequency ablation of recurrent hepatocellular carcinoma with successful hemostasis achieved through transarterial embolization: a case report

Acute massive abdominal hemorrhage after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is an infrequent and severe complication. Delayed diagnosis and treatment may be life-threatening. We herein describe a 60-year-old man with a history of postoperative HCC. A new nidus of HCC was found in his right liver lobe after abdominal magnetic resonance imaging and intraoperative angiography. The patient then underwent computed tomography-guided RFA. However, 7 hours after RFA, he suddenly developed dizziness, nausea, abdominal distension, hematuria, a decreased blood pressure, and an increased heart rate. Diagnostic abdominal puncture produced bloody liquid, and angiography demonstrated hemorrhage in the right hepatic artery. Transarterial embolization was performed following the administration of an appropriate amount of tissue emulsion to embolize the source of hemorrhage. Following this treatment, the patient had no further bleeding. Neither the hemorrhage nor the HCC lesions had recurred after 3 months of follow-up.