Hypovolemic shock induced by laparoscopic cholecystectomy--a case report

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學系 > 期刊論文 > Item 310902500/3489

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Title:	Hypovolemic shock induced by laparoscopic cholecystectomy--a case report
Authors:	Tseng, Y H;Ho, W M;Hung, W T
Contributors:	中山醫學大學：醫學系
Date:	1997
Issue Date:	2011-03-01T02:44:22Z (UTC)
Abstract:	AB Since its introduction and development in the 1960s, laparoscopic cholecystectomy has become widely accepted by the medical community and the public as the treatment of choice for various gallbladder disorders. We present a 46-year-old male who underwent laparoscopic cholecystectomy, during which inadvertent penetration of the first trocar resulted in injury of the abdominal aorta and then hypovolemic shock ensured. The time from notification of shock by the anesthesiologist to switch of procedure to exploratory laparotomy for stanching hemorrhage was twenty minutes. During the intervention, blood loss was over 3,000 ml and despite rapid infusion of plasma expander, blood pressure could only be maintained between 40/18 to 60/20 mmHg. After the patient became stabilized and blood pressure was elevated to acceptable levels, conventional cholecystectomy was performed instead. Perioperative blood loss of 7,300 ml was estimated. In total, the patient received 24 units of packed red blood cells, 12 units of fresh frozen plasma, and 12 units of platelets. After the operation, the patient was transferred to the surgical ICU for further observation. For 24 h at the ICU, blood pressure remained unstable, urine output decreased gradually, and scrotal and leg edema developed. Forty-four h after admission to the surgical ICU, arrhythmia and profound hypotension were noted and cardiac arrest ensued. After resuscitation for 2 h, the patient could not be revived and succumbed to cardiovascular decompensation secondary to acute renal shutdown and continuous retroperitoneal hemorrhage.
URI:	https://ir.csmu.edu.tw:8080/handle/310902500/3489
Relation:	Acta Anaesthesiologica Sinica. 35(4):247-52, 1997 Dec.
Appears in Collections:	[醫學系] 期刊論文

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