Post-embolisation syndrome (PES) is one of the commonest side effects of transarterial embolisation and chemoembolisation. It comprises of a constellation of fever, nausea/vomiting, and pain. It usually occurs within the first 72 hours after embolisation (liver lesion or uterine fibroids) and then starts to subside after 72 hours 1.
It is not to be mistaken for a predictor of impending infection. Hence performing blood cultures in the absence of other factors is unnecessary 1.
This condition is more often associated with large fibroids or large tumour embolisation.
Early imaging following embolisation, either by ultrasound or CT, may reveal intralesional gas. This is not to be mistaken for abscess without additional factors 3.
Treatment and prognosis
Treatment is symptomatic relief; analgesia, IV fluids and TLC from a caring nursing 1. It is normally self-limited 2. Prophylactic use of antipyretic and antiemetic therapy may be considered prior to embolisation of large tumours/ fibroids.
- 1. Kessel D, Robertson I. Interventional radiology, a survival guide. Churchill Livingstone. (2005) ISBN:0443100446. Read it at Google Books - Find it at Amazon
- 2. Castells A, Bruix J, Ayuso C et-al. Transarterial embolization for hepatocellular carcinoma. Antibiotic prophylaxis and clinical meaning of postembolization fever. J. Hepatol. 1995;22 (4): 410-5. J. Hepatol. (link) - Pubmed citation
- 3. Gates J, Hartnell GG, Stuart KE et-al. Chemoembolization of hepatic neoplasms: safety, complications, and when to worry. Radiographics. 19 (2): 399-414. Radiographics (full text) - Pubmed citation