Location
Moultrie, GA
Start Date
7-5-2025 1:00 PM
End Date
7-5-2025 4:00 PM
Description
Background: Laparoscopic surgery offers many advantages over open surgery and this includes colon resections both for benign and malignant diseases. Whereas surgical complications especially infections seem to be lower after the minimally invasive approach, the incidence of postoperative medical complications such as pulmonary embolism or myocardial infarction is not impacted. Massive myocardial infarction with ventricle rupture is an extremely rare and in almost all cases fatal condition. This has not been reported as a postoperative complication.
Case report: A 75 year old male developed stool irregularities and blood per rectum and during work up was found to have a malignant lesion in the ascending colon. He was an active smoker but had no symptoms of coronary artery disease, specifically no chest pain or shortness of breath. After cardiac clearance, he underwent laparoscopic right hemicolectomy. The intra and early postoperative course was uneventful. He passed gas on the third day and had a bowel movement on the 4th day after surgery and plans were made for discharge. However, the next morning he became diaphoretic and developed chest pain and shortness of breath. He lost consciousness and a code was called. He was intubated and brought to the intensive care unit. EKG showed acute myocardial infarction. Due to hemodynamic instability, he underwent CT-scan, which showed extravasation of contrast from the left ventricle with developing cardiac tamponade. After discussing the dismal situation with his wife, comfort care was initiated and the patient died within an hour.
Discussion: To the best of our knowledge a ventricle rupture after laparoscopic surgery or a colectomy has not been reported thus far. One may argue that in long term smokers even without chest pain or shortness of breath and a normal EKG, a more sophisticated workup including echocardiography and/or stress test may have prevented this devastating complication.
Embargo Period
6-2-2025
Included in
Massive Myocardial Infarction with Ventricular Rupture following Laparoscopic Colectomy for Colorectal Cancer: A Devastating Complication
Moultrie, GA
Background: Laparoscopic surgery offers many advantages over open surgery and this includes colon resections both for benign and malignant diseases. Whereas surgical complications especially infections seem to be lower after the minimally invasive approach, the incidence of postoperative medical complications such as pulmonary embolism or myocardial infarction is not impacted. Massive myocardial infarction with ventricle rupture is an extremely rare and in almost all cases fatal condition. This has not been reported as a postoperative complication.
Case report: A 75 year old male developed stool irregularities and blood per rectum and during work up was found to have a malignant lesion in the ascending colon. He was an active smoker but had no symptoms of coronary artery disease, specifically no chest pain or shortness of breath. After cardiac clearance, he underwent laparoscopic right hemicolectomy. The intra and early postoperative course was uneventful. He passed gas on the third day and had a bowel movement on the 4th day after surgery and plans were made for discharge. However, the next morning he became diaphoretic and developed chest pain and shortness of breath. He lost consciousness and a code was called. He was intubated and brought to the intensive care unit. EKG showed acute myocardial infarction. Due to hemodynamic instability, he underwent CT-scan, which showed extravasation of contrast from the left ventricle with developing cardiac tamponade. After discussing the dismal situation with his wife, comfort care was initiated and the patient died within an hour.
Discussion: To the best of our knowledge a ventricle rupture after laparoscopic surgery or a colectomy has not been reported thus far. One may argue that in long term smokers even without chest pain or shortness of breath and a normal EKG, a more sophisticated workup including echocardiography and/or stress test may have prevented this devastating complication.