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[Hemothorax as complication of laparoscopic technique]
1Servicio de Anestesiología y Reanimación, Ciudad Sanitaria y Universitaria de Bellvitge (CSUB). mterealcazar@hotmail.com
Revista Espanola De Anestesiologia Y Reanimacion
|April 24, 2003
Summary
A rare case of intraoperative bleeding into the pleural cavity during laparoscopic Nissen fundoplication required emergency surgery. This highlights the need for vigilant anesthetic monitoring during complex laparoscopic procedures.
Area of Science:
- Anesthesiology
- Surgical Complications
- Gastrointestinal Surgery
Background:
- Laparoscopic Nissen fundoplication is a common procedure for gastroesophageal reflux disease.
- Standard laparoscopic complications include pneumothorax, perforation, and hemorrhage.
Observation:
- A 69-year-old woman developed sudden, severe hypotension and respiratory compromise at the end of laparoscopic Nissen fundoplication.
- Intraoperative interventions were initiated, but hemodynamic instability persisted post-extubation.
- Chest radiography revealed left hemothorax, necessitating emergency thoracotomy.
Findings:
- Hemorrhage originated from the right crus of the diaphragm.
- Bleeding was successfully arrested during thoracotomy.
- The patient recovered without further complications.
Implications:
- This case underscores the potential for diaphragmatic injury and intrapleural bleeding during laparoscopic fundoplication.
- Rigorous intraoperative monitoring and prompt postoperative surveillance are crucial for anesthesiologists.
- Awareness of uncommon complications is vital for managing complex laparoscopic surgeries.