Hypotension due to compression of the inferior vena cava by intrathoracic herniation of peritoneal fat during laparoscopic surgery: A case report
10.17085/apm.2018.13.1.72
- Author:
Mijung YUN
1
;
Gunn Hee KIM
;
Seung Young LEE
;
Hana CHO
;
Byung Uk KIM
;
Min Seok KOO
;
Mi Young KWON
Author Information
1. Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea. gunnhee@gmail.com
- Publication Type:Case Report
- Keywords:
Inferior vena cava;
Laparoscopy
- MeSH:
Carbon Dioxide;
Edema;
Humans;
Hypotension;
Laparoscopy;
Lower Extremity;
Obesity, Abdominal;
Pneumoperitoneum;
Skin;
Superior Vena Cava Syndrome;
Ulcer;
Vena Cava, Inferior
- From:Anesthesia and Pain Medicine
2018;13(1):72-76
- CountryRepublic of Korea
- Language:English
-
Abstract:
Vena cava syndrome is caused by central venous obstruction and can be divided into superior vena cava syndrome and inferior vena cava (IVC) syndrome. Symptoms and signs of IVC syndrome vary from no symptoms to lower limb edema, hypotension, and typical venous stasis changes of the lower extremities, such as brownish discoloration of the skin, woody edema, and ulceration. Carbon dioxide pneumoperitoneum, lithotomy-Trendelenburg position, and abdominal obesity could increase intra-abdominal pressure. We report a patient undergoing laparoscopic surgery who showed intrathoracic herniation of peritoneal fat induced by elevated intra-abdominal pressure due to the reasons mentioned above, resulting in IVC syndrome and hypotension perioperatively. The patient was treated with a conservative approach because he was asymptomatic except for hypotension on the first postoperative day.
