ABSTRACT
We report a 49-year-old lady who presented with acute Budd-Chiari syndrome. Spiral CT scan showed inferior vein cava (IVC) tumor and ischemia of the right liver secondary to hepatic vein blockage. These were confirmed by MRI scan and IVC gram, at which time tissue diagnosis was obtained. At surgery, the tumor was seen to originate from the infrahepatic IVC and extended to the level of the diaphragm, blocking the hepatic vein outflow. The tumor was excised completely. Histology confirmed it to be leiomyosarcoma of the IVC. The patient is well, without recurrence of symptoms or tumor, 10 months later.
Subject(s)
Budd-Chiari Syndrome/diagnosis , Leiomyosarcoma/diagnosis , Vascular Neoplasms/diagnosis , Vena Cava, Inferior , Acute Disease , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Leiomyosarcoma/physiopathology , Leiomyosarcoma/surgery , Middle Aged , Vascular Neoplasms/physiopathology , Vascular Neoplasms/surgeryABSTRACT
We present an unusual sequence of events leading to massive cerebral air embolism and death in a patient who underwent mitral valve re-replacement for failure of the previously inserted bioprosthetic valve. An iatrogenic communication was created inadvertently between the adherent lung parenchyma and the left atrium. It caused a massive influx of air from the lung into the left atrium and systemic circulation causing fatal cerebral embolization. Retroperfusion was not effective.
