Surgical hypothermia and its postoperative challenges: A case report

Area of Science:

• Medicine
• Surgery
• Anesthesiology

Background:

• Intraoperative hypothermia is a common complication in major surgeries, leading to issues like coagulopathy and delayed healing.
• While systemic effects are known, localized bleeding complications such as hemorrhagic pleural effusion and cervical hematoma are rarely attributed to hypothermia.

Purpose of the Study:

• To report a rare case of intraoperative hypothermia leading to hemorrhagic pleural effusion and cervical hematoma after an esophagectomy.
• To highlight the potential for hypothermia-induced coagulopathy to cause severe, localized bleeding complications.

Main Methods:

• Case report of a 21-year-old male undergoing esophagectomy with significant intraoperative hypothermia (core temperature 34°C).
• Detailed description of postoperative development of hemorrhagic pleural effusion and cervical hematoma.
• Analysis of the likely cause as hypothermia-induced coagulopathy.

Main Results:

• The patient developed a hemorrhagic pleural effusion and a cervical hematoma post-surgery.
• The cervical hematoma caused respiratory compromise, necessitating emergency surgical intervention.
• These complications led to prolonged recovery and extended hospital stay in the Surgical Intensive Care Unit.

Conclusions:

• Intraoperative hypothermia can lead to rare but life-threatening complications, including hemorrhagic pleural effusion and compressive neck hematoma.
• Highlights the need for improved intraoperative warming strategies and prompt recognition/management of postoperative bleeding complications.
• Underscores the importance of close temperature monitoring and early intervention, especially after major surgical procedures.