Six surgeries save man from serious vascular malformations in his liver in UAE

A medical team in Abu Dhabi managed to save the life of a 36-year-old man after he was diagnosed with a dangerous liver aneurysm, caused by a rare genetic condition affecting the walls of blood vessels. The team performed six successful surgeries on the patient.

Earlier, the patient went to Burjeel Hospital in Abu Dhabi after experiencing increasing pain in his back and left chest. Tests revealed a leak in one of his blood vessels, which was later found to be linked to a rare hormonal disorder caused by a hormone called adrenaline, which damages the muscular walls of his body’s blood vessels.

The patient underwent several delicate surgeries performed by a multidisciplinary team, during which doctors faced formidable challenges in balancing blood flow and preventing bleeding, but they eventually succeeded in controlling the condition and saving his life.

“The patient’s condition could have been fatal if it had not been treated in time,” said Dr. Moatasiem Bukhari, Consultant Vascular Surgeon at Burjeel Hospital, Abu Dhabi, adding that the patient was taking painkillers before being taken to the emergency department.

“Because the painkillers he had been taking for the past few days did not relieve the pain, a CT angiogram was performed, which revealed a leak from an aneurysm in the blood vessel supplying the left side of his liver,” he said.

Dr. Bukhari recommended endovascular coiling to treat the aneurysm, during which small coils were inserted into the blood vessel feeding the aneurysm to block blood flow to the bulge and prevent further leakage.

Dr. Mohammed Al Marzooqi, Medical Director and Consultant Interventional Radiologist, successfully performed this procedure through a small incision in the right thigh, a standard method for treating this type of aneurysm.

After coiling, a pseudoaneurysm formed in the wall of the main artery in the patient’s right thigh. A pseudoaneurysm forms when a blood vessel wall ruptures or is damaged, causing blood to leak and accumulate outside the vessel, forming a blood-filled cyst.

Because the condition was initially diagnosed as small, the medical team decided to treat it transcutaneously with an injection of a substance that would remove the pseudoaneurysm. However, the aneurysm enlarged and ruptured on the following day, prompting the team to opt for open surgery.

“The patient’s right thigh was bleeding profusely and open surgery was the only option available to stop the bleeding,” Dr. Bukhari explained.

“We made a small incision in the lower abdomen to control the main blood vessel leading to the right leg. A perforation was found in the common femoral artery and was closed,” he added, noting that during the operation, three liters of blood were withdrawn to control the severe bleeding and stabilize the patient until the artery was repaired and any further complications prevented.

The medical team had to balance two conflicting conditions where the patient required blood thinning to prevent clots. This was dangerous because he was also bleeding from other blood vessels, making treatment extremely difficult and inconsistent.

During the operation, Dr. Khaled Hassan Attia Ghorab, consultant critical care medicine, led the critical care team, while Dr. Mohsin Saleem Basade, radiology specialist, led the anesthesia team.

Although the patient has passed the critical stage, he still requires long-term follow-up care. According to Dr. Bukhari, the patient has approximately seven aneurysms and four to five severe arterial dissections, which require regular monitoring through multiple tests.

“The pain was severe and affected my daily life and things were difficult at first,” the patient said, recalling his first days. “I realized that I had to accept the situation and undergo these procedures to get my life back. I pray to Allah that my life will change for the better. I am grateful to the medical team for providing the highest level of care to me and to my family, especially my mother, who stood by me during the surgery and recovery phases,” he added.

The medical team noted that the patient was currently on the way to recovery, with his wounds healing well, and he is determined to prioritize his health, work, and family after his discharge from the hospital.