Background: Sclerosing cholangitis is a form of cholestatic disease with vanishing bile duct disorders and can be induced secondarily by various causes or be of iatrogenic origin. Several cases of
secondary sclerosing cholangitis after hepatic arterial infusion chemotherapy also have been described.Case Report: We report a 47-year-old male patient on whom surgical resection and additional hepatic arterial chemotherapy infusion were performed for hepatocellular carcinoma. There was no evidence of recurrence or metastases, but secondary sclerosing cholangitis developed with bacterial inflammation. As a result, multiple organ dysfunction was induced within the shortterm and progressed rapidly to death. An uncommon drastic change, “complete occlusion” in the area of the common hepatic artery, was distinct on an arteriogram and this ischemic change was presumed to be the main cause of the sclerosing cholangitis.Conclusions: Ongoing inflammation, renal dysfunction, perhaps due to an adverse effect of treatment with antibiotics, and failure of host defense mechanisms may have been the major factors inducing multiple organ failure. It seems quite unlikely that occlusion of the common hepatic artery was the primary cause of the progressive bile duct destruction because intensive care did not lead to sustained improvement.

Keywords: sclerosing cholangitis, bile duct, Multiple Organ Failure, hepatic arterial infusion chemotherapy