Fatal liver abscess caused by Clostridium perfringens complicated with transarterial chemoembolization

A 77-year-old man who received transarterial chemoembolization for large hepatocellular carcinomas complained of acute pain in the upper abdomen and suddenly developed severe jaundice, anemia, and massive hematuria. Abdominal computed tomography demonstrated gas gangrene at the tumor site. Clostridium perfringens was identified from blood samples and drainage cultures from the liver abscess. Despite intensive treatment, the patient died 55 hours after chemoembolization due to multiple organ failure. When treating patients with large tumors, such as in our case, this rare but fatal complication that causes sepsis and hemolysis with lightning-like rapidity should be considered.