SARS-CoV-2-Infektion und „In-situ-Split“-Leberresektion mit tödlichem Verlauf

Wir berichten über den perioperativen Verlauf eines 47-jährigen Patienten, der sich aufgrund eines bilobär metastasierten kolorektalen Karzinoms einer zweizeitigen Leberresektion unterziehen musste und 8 Tage später verstarb.

Abstract

We report the perioperative course of a 47-year-old patient who underwent a two-stage liver resection for bilobar metastatic colorectal carcinoma. The respiratory asymptomatic patient was tested positive for SARS-CoV-2 by PCR detection one day before the second surgical procedure. Postoperatively, the patient suffered cardiovascular arrest on postoperative day 8 and died despite immediately initiated resuscitative measures. With an initial clinical suspicion of vascular liver failure, postmortem pathologic examination revealed the underlying cause of death to be COVID-19-related myocarditis with acute right heart failure. Individual multidisciplinary risk assessment should be considered very critically when deviating from the „7-week rule“ because the benefit is difficult to objectify, even in oncologic patients.

Kernaussagen

• Positiv auf SARS-CoV-2 getestete, aber klinisch asymptomatische Patientinnen und Patienten besitzen ein relevantes Risiko für schwere COVID-19-bedingte Komplikationen.

• Perioperativ kann bei SARS-CoV-2-positiven Patienten ein erhöhtes Mortalitätsrisiko bestehen.

• Die Entscheidung zur Abweichung von der „7-Wochen Regel“ sollte interdisziplinär, unter Abwägung und Kenntnis aller Befunde, sehr kritisch erfolgen.

Schlüsselwörter

SARS-CoV-2 - Myokarditis - In-situ-Split-Leberresektion - perioperative Mortalität

Keywords

myocarditis - Covid - “in situ split” liver resection - perioperative mortality

Publication History

Article published online:
06 December 2023

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