L R Jiao1, J R Tysome, G Navarra, N A Habib. 1. Department of Surgical Oncology and Technology, Imperial College School of Medicine, Hammersmith Hospital Campus, Du Cane Road, London W12 ONN, 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.
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.
Authors: Jean-Christophe Weber; Giuseppe Navarra; Long R Jiao; Joanna P Nicholls; Steen Lindkaer Jensen; Nagy A Habib Journal: Ann Surg Date: 2002-11 Impact factor: 12.969
Authors: B Cady; R L Jenkins; G D Steele; W D Lewis; M D Stone; W V McDermott; J M Jessup; A Bothe; P Lalor; E J Lovett; P Lavin; D C Linehan Journal: Ann Surg Date: 1998-04 Impact factor: 12.969
Authors: R B Griepp; M A Ergin; J D Galla; S L Lansman; J N McCullough; K H Nguyen; J J Klein; D Spielvogel Journal: Ann Thorac Surg Date: 1999-06 Impact factor: 4.330
Authors: K S Hughes; R Simon; S Songhorabodi; M A Adson; D M Ilstrup; J G Fortner; B J Maclean; J H Foster; J M Daly; D Fitzherbert Journal: Surgery Date: 1986-08 Impact factor: 3.982
Authors: E A Bastounis; E S Felekouras; A J Arvelakis; S E Georgopoulos; J Griniatsos; E L Papalambros Journal: HPB (Oxford) Date: 2002 Impact factor: 3.647