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Hypovolemic shock induced by laparoscopic cholecystectomy--a case report
1Department of Anesthesiology, Hospital of Chung Shan Medical and Dental College, Taiwan, R.O.C.
Acta Anaesthesiologica Sinica
|April 29, 1998
Summary
A laparoscopic cholecystectomy complication led to abdominal aortic injury and hypovolemic shock. Despite extensive resuscitation, the patient experienced multi-organ failure and succumbed to cardiovascular decompensation.
Area of Science:
- Surgical Complications
- Minimally Invasive Surgery
- Vascular Injury
Background:
- Laparoscopic cholecystectomy is the standard treatment for gallbladder disorders.
- Trocar insertion is a critical step with potential for serious complications.
Observation:
- A 46-year-old male sustained an abdominal aortic injury during laparoscopic cholecystectomy.
- This resulted in immediate hypovolemic shock, with blood loss exceeding 3,000 ml during the initial intervention.
Findings:
- The patient underwent conversion to open surgery for hemorrhage control, with an estimated perioperative blood loss of 7,300 ml.
- Despite massive transfusion and ICU care, he developed unstable blood pressure, decreased urine output, edema, and eventually cardiac arrest.
- Cardiovascular decompensation secondary to acute renal shutdown and retroperitoneal hemorrhage led to the patient's demise.
Implications:
- This case highlights the critical risk of major vascular injury during laparoscopic procedures.
- Prompt recognition and management of shock are vital, but severe injuries can still lead to fatal outcomes.
- It underscores the importance of meticulous surgical technique and preparedness for catastrophic complications in minimally invasive surgery.