ACUTE PANCREATITIS AFTER TRANSARTERIAL CHEMOEMBOLIZATION BEFORE LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA: A CASE REPORT.

Introduction: Acute pancreatitis is one of the rare complications of transcatheter arterial chemoembolization with an incidence ranging from 2% (clinical pancreatitis) to 40% (biological pancreatitis). It may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. This complication has a significant morbidity and mortality potential when it is associated with other complications. Case report: We report a case of acute pancreatitis in a 58 year-old North African male, developed within 24h after a first selective chemoembolization proposed as locoregional bridge therapy for the treatment of hepatocellular carcinoma before liver transplantation. In this case, the first possible etiology of acute pancreatitis was transcatheter arterial chemoembolization, because there were no other causes of acute pancreatitis, the chronology was compatible and the vascular opacification has showed a regurgitation of embolic materials during the procedure .Through this case and review of literature, we focused on the mechanisms and diagnosis difficulties of acute pancreatitis following chemoembolization. Conclusion: Acute pancreatitis is a rare complication of transcatheter arterial chemoembolization, and may clinically mimic a postembolization syndrome at the early stage. The knowledge of this complication must lead to a systematic monitoring of serum pancreatic enzymes in cases of abdominal pain after chemoembolization.