A Delayed Hepatico-colonic Fistula after Radiofrequency Ablation in Hepatocellular Carcinoma

Percutaneous radiofrequency thermal ablation (RFA) performed under ultrasound guidance is a safe, effective therapeutic modality for managing liver malignancies. Although surgical resection remains the treatment of choice for hepatocellular carcinoma (HCC), RFA has emerged as a reliable alternative. Potential complications of RFA include liver abscess, ascites, pleural effusion, skin burns, hypoxemia, pneumothorax, subcapsular hematoma, hemoperitoneum, liver failure, tumor seeding, and biliary lesions. Here, we report a rare complication after RFA for HCC: a delayed liver abscess and transverse colonic fistula. The patient was treated successfully with percutaneous abscess drainage, antibiotics, liver segmentectomy, and segmental resection of the fistula and involved colon. Due to its rarity, we report this case and review the literature. (Korean J Med 2014;86:722-727)