# Feasibility of Synchronous Liver Metastasectomy During Emergency Colorectal Surgery: A Case Report

## TL;DR

A patient with colorectal cancer and a liver metastasis underwent emergency surgery and later showed no signs of active disease.

## Contribution

This case report highlights the feasibility of synchronous liver metastasectomy during emergency colorectal surgery.

## Key findings

- The patient underwent Hartmann’s sigmoidectomy and left lateral hepatic resection simultaneously.
- The patient was disease-free nine months post-surgery after adjuvant chemotherapy.
- The case emphasizes the need for further research on synchronous metastasectomy in emergency settings.

## Abstract

Colorectal cancer (CRCa) is the most frequent gastrointestinal (GI) malignancy, while the liver is the most common site of distant metastases from CRCa, arising from hematogenous spread mainly via the portal venous system. The multiform nature of tumor presentation necessitates a comprehensive approach to diagnosis, perioperative care, and oncological treatment strategy. Herein, we present a case of a 76-year-old male patient diagnosed with obstructive bowel ileus due to a sigmoid tumor with synchronous, suspicious for metastasis, liver lesion who underwent Hartmann’s sigmoidectomy in conjunction with left lateral hepatic resection at the same time. Intraoperatively significant blood loss occurred, while the postoperative course of the patient included pulmonary embolism (PE) six days after the procedure, being discharged on postoperative day (POD) 21. After oncological consensus, the patient underwent adjuvant chemotherapy and his reevaluation nine months after surgery confirmed that he is free of active disease. It is evident, however, that the number of existing studies concerning synchronous metastasectomy alongside CRCa resection in an emergency setting is limited and the literature gaps on this matter emphasize the need for further research.