Hemorrhagic cardiac tamponade after percutaneous laser ablation of a liver metastasis in segment II

Abstract

Despite percutaneous laser thermal ablation (LTA) of liver tumors being regarded as a safe technique, major complications can occur. We report the first case of hemorrhagic cardiac tamponade after LTA of a colorectal metastasis in segment II of the liver. Unpredictable heat diffusion causing indirect thermal injury to the pericardium with resultant hemorrhagic reaction was hypothesized as the most likely cause of tamponade. A pericardial drain was emergently placed, 200 mL of bright red blood were drained, and the patient showed rapid hemodynamic improvement. For lesions located in segment II of the liver and strictly close to the pericardium, a careful risk/benefit analysis should be made by the multidisciplinary team to identify the best treatment option, taking into account both effectiveness and complications of each available technique.

Keywords

Laser thermal ablation / liver tumors / complications / cardiac tamponade

References

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