Bleeding gastric ulcer after prophylactic coiling of transarterial chemoembolization.

Transarterial chemoembolization is standard treatment for unresectable hepatocellular carcinoma. Prophylactic embolization of variant hepatic or gastric arteries before treatment of liver tumors reduces inadvertent injury to adjacent organs. This report presents a patient with multiple hepatocellular carcinomas, who developed an episode of acute gastric ulcer bleeding because of coil migration into the stomach 2 years after prophylactic embolization of the accessory right gastric artery for transarterial chemoembolization. This report discusses the purpose of prophylactic embolization, complications of coil embolization, various presentations and possible mechanisms of coil migration, and treatment of gastrointestinal bleeding. It also reviews pertinent literature.