An 84-year-old female patient was brought to the emergency department in cardiac arrest. Cardiopulmonary resuscitation maneuvers were performed but were unsuccessful. The patient had a past medical history of systemic arterial hypertension with target-organ lesions, including stroke and myocardial infarction. The autopsy was carried out, and the most striking finding was cardiac tamponade due to the rupture of an ascending aortic aneurysm at the site of a complex atheromatous plaque. Rupture is the most serious complication of a thoracic aneurysm and must be considered in the differential diagnosis of sudden death.

This study was use MI-3DVS system reconstruction 30 cases of hepatic trauma patients, observation of three-dimensional imaging features of liver trauma. Methods: Application of MI-3DVS system for 3D reconstruction of patients with liver trauma, the trauma site, nature, scope by three-dimensional reconstruction, if the patients need for operation, in comparison with preoperative 3D reconstruction, can help physicians decide the size of operation mode, operation range. Results: 30 cases of traumatic patients were 20 cases of closed liver injury and 10 cases of open injury of the liver. 21 cases of patients with preoperative three-dimensional reconstruction model showed the intrahepatic vascular injury, need operation, the preoperative 3D reconstruction of consensus was found in operation. 9 cases of preoperative three-dimensional reconstruction model did not show the intrahepatic vascular injury, conservative treatment for patients with successful. All 30 patients recovered and were discharged from hospital. Conclusion: Abdominal medical image visualization system (MI-3DVS) 3D data can be rapid and efficient completion of the liver of 64 row spiral CT program segmentation, 3D reconstruction, 3D image can completed reflection the liver trauma, it makes doctors have a more comprehensive understanding and diagnosis before the operation, make the operation more precise, so that patients receive timely treatment correctly, abdominal medical image system has a good applied future in the diagnosis and treatment of liver trauma.

In instances were a large amount of parenchyma is sacrificed (i.e. extended hepatectomies) the main concern is the risk of postoperative liver failure. Strategies employed to reduce the risk of postoperative liver failure are staged operations, portal vein ligation and portal vein embolization (PVE). A recent strategy, "Associating Liver Partition and Portal vein Ligation for Staged hepatectomy" e termed ALPPS e appeared as an interesting approach to induce massive hypertrophy in a short time period. This was a clear benefit over the previous techniques, but brings a costly result on morbidity and mortality, respectively up to 90% and 28.7% of patients. Methods: This case series aims to report a successful strategy of patient selection to reduce morbidity and mortality associated with the ALPPS procedure. Patients were selected for surgery as indicated: age under 60 years; no severe comorbidities (ASA 1 or 2); no cholestasis; no previous biliary instrumentation (i.e. ERCP); insufficient hypertrophy after PVE; no associated major abdominal operation. Results: Between November 2011 and January 2015 8 patients undergone ALPPS. There were 7 male patients with an average age of 52 years. Mean time between the two operative stages was 8 days. Mean hypertrophy of the future remnant was 67%, there were 2 complications (25%) and no deaths occurred. Conclusion: ALPPS is a debatable new strategy that offers the opportunity of complete resection of advanced tumors and reduces the risk of postoperative liver failure. In order to avoid operative complications, patient selection plays a key role in this procedure.