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

Authors

  • L. R. JIAO,

    1. Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
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  • J. R. TYSOME,

    1. Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
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  • G. NAVARRA,

    1. Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
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  • N. A. HABIB

    Corresponding author
    1. Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
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N. A. Habib, Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK. E-mail: nagy.habib@ic.ac.uk

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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