Usability of Esophageal Doppler for Monitoring of Concealed Retroperitoneal Hemorrhage during Laparoscopy Assisted Subtotal Gastrectomy.
10.4266/kjccm.2012.27.2.134
- Author:
Sung Ha MUN
1
;
Seung Hwan LEE
;
Min Young NO
Author Information
1. Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea. anesmun@hanmail.net
- Publication Type:Case Report
- Keywords:
esophageal doppler monitor;
hypovolemia;
retroperitoneal hemorrhage
- MeSH:
Blood Pressure;
Cardiac Output;
Catheterization, Swan-Ganz;
Central Venous Pressure;
Gastrectomy;
Heart Rate;
Hemodynamics;
Hemorrhage;
Humans;
Hypovolemia;
Laparoscopy;
Laparotomy;
Surgical Instruments
- From:The Korean Journal of Critical Care Medicine
2012;27(2):134-138
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hemodynamic monitoring is an essential element in the management of perioperative patients. In addition, anesthesiologists routinely used blood pressure (invasive or non invasive), heart rate, urinary output and central venous pressure as monitoring modalities. Esophageal doppler monitoring, as a minimally invasive hemodynamic assessment tool, has a good correlation with pulmonary artery catheterization in measuring cardiac output. We experienced a case of concealed retroperitoneal hemorrhage in a patient who underwent a laparoscopic subtotal gastrectomy. When surgeons tried to close trocar sites, the patient's blood pressure dropped rapidly. At laparoscopy, we could not find gross bleeding. However, we could detect hypovolemia by esophageal doppler monitoring (CardioQ, Deltex(TM), UK). The procedure was converted to open laparotomy. Thereafter, we could find retroperitoneal hemorrhage, and vascular repair was done successfully. The patient recovered without any other complications.
