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. 2005;7(1):73-6.
doi: 10.1080/13651820410033643.

Liver resection in a patient with concomitant thoraco-abdominal and cerebral aneurysms

L R Jiao  1 , J R Tysome, G Navarra, N A Habib
Affiliations

Liver resection in a patient with concomitant thoraco-abdominal and cerebral aneurysms

L R Jiao et al. HPB (Oxford). 2005.

Abstract

Background: Surgical resection remains the only curative procedure for liver metastases but even in expert hands it has appreciable morbidity and mortality rates. The presence of a concomitant aortic aneurysm greatly increases these risks.

Case outline: A 66-year-old woman who was known to have large aneurysms of the thoraco-abdominal aorta and middle cerebral artery presented with colorectal liver metastases. After detailed preoperative assessment, she underwent resection of segments V and VI of the liver. The surgical procedure was uneventful. She made a good initial recovery, but on day 7 she suddenly became hypotensive and died from a cardiorespiratory arrest. Post-mortem examination revealed a ruptured thoracic portion of the thoraco-abdominal aortic aneurysm.

Conclusion: Despite careful control of perioperative blood pressure and the lack of abdominal complication, intrathoracic aneurysmal rupture on day 7 highlights the risk of major unrelated operations in patients with aneurysmal disease.

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Figures

Figure 1.
Figure 1.
(a) Chest X-ray and (b) CT scan of the abdomen showing the thoraco-abdominal aortic aneurysm.
Figure 2.
Figure 2.
The intra-operative picture shows the colorectal liver metastasis adherent to gallbladder which has been lifted up after dissection, and IVC.
Figure 3.
Figure 3.
Post RFA-assisted liver resection.
See this image and copyright information in PMC

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