Unexpected Complications After Excision Of Splenic Aneurysm In Osler-Weber-Rendu Disease

Abstract

Osler-Weber-Randu disease is an autosomal dominant disease, sometimes known as hereditary hemorrhagic telangiectasia (HHT) with a family history. It is a rare disease and there are no records of families with inheritance lineage in Riyadh. We experienced anesthetic management of a 28-yr-old woman with Osler-WeberRandu disease. She was diagnosed to have splenic aneurysm and was scheduled for the repair of the aneurysms. A chest X-ray revealed pulmonary arterio-venous malformation all over the lungs. The anesthesia and surgery went deliberately smoothly with selective period of intensive care admission. In the intermediate post operative period she was diagnosed as having pleural effusion and chest drain was inserted as emergency, but the patient developed tension pneumothorax, which necessitated resuscitation and readmission to intensive care unit. Reconsideration to the initial diagnosis went in the direction of lung atelectasis. On the ground of low experience of the surgical night staff and lack of communication there are good lesson to be considered namely vigilance not to be reduced, communication, and consultation are as important as the properly conducted management of such rare cases.