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Non-thoracic Source of Bleeding During Left-sided Thoracic Surgery
Jonathan B Cohen1, Michael R Hirschi2, Sephalie Y Patel1
1Anesthesiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Cureus
|July 17, 2019
Summary
Hypotension during thoracic surgery can have unexpected causes. This case highlights intra-abdominal bleeding, not intrathoracic issues, as a critical factor in post-operative hypotension.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Surgical Complications
Background:
- Hypotension during thoracic surgery is often linked to intrathoracic events like bleeding or ventilation changes.
- Decreased venous return and myocardial contractility are commonly cited intrathoracic causes.
Observation:
- A patient experienced unexplained hypotension at the conclusion of a left-sided thoracic procedure.
- Initial assessments did not reveal typical intrathoracic causes for the drop in blood pressure.
Findings:
- The hypotension was definitively linked to intra-abdominal hemorrhage originating from a splenic injury.
- This underscores the importance of considering non-thoracic sources of bleeding.
Implications:
- Anesthesiologists must maintain vigilance for extra-thoracic causes of hypotension, particularly during left-sided lung surgeries.
- This case emphasizes a broader differential diagnosis for perioperative hypotension in thoracic surgery patients.
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