Cardiac arrest that developed during anesthetic induction in a patient with abdominal gas gangrene: A case report.
10.4097/kjae.2009.57.1.127
- Author:
Duk Kyung KIM
1
;
Seong Hyop KIM
;
Tae Gyoon YOON
;
Sung Whwan JANG
;
Jun Hee YI
;
Young JOO
Author Information
1. Department of Anesthesiology and Pain Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea. dikei@kuh.ac.kr
- Publication Type:Case Report
- Keywords:
Extracoporeal membrane oxygenation;
Gas gangrene;
Septic shock
- MeSH:
Abdominal Muscles;
Abdominal Pain;
Anesthesia;
Anesthesia, General;
Catecholamines;
Catheterization;
Debridement;
Emergencies;
Fascia;
Fever;
Gas Gangrene;
Gastrectomy;
Heart Arrest;
Humans;
Laparotomy;
Membranes;
Middle Aged;
Oxygen;
Resuscitation;
Shock, Septic;
Skin;
Subcutaneous Emphysema;
Vascular Access Devices
- From:Korean Journal of Anesthesiology
2009;57(1):127-131
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report here on a fatal case of abdominal gas gangrene. Two days after gastrectomy, a 56-year-old man presented with intractable abdominal pain and fever of a sudden onset, which quickly progressed over several hours to septic shock. Despite of the unexplained gas collections in the abdominal muscle, fascia, and subcutaneous layers on computed tomography scan, its clinical significance was overlooked. Emergency laparotomy was initially scheduled because of concern that there may have been a perforated viscus. At the time of monitoring for the anesthesia, we noticed marbled skin discoloration and the subcutaneous emphysema had spread on his flank. Shortly after the initial suspicion of gas gangrene, cardiac arrest developed during the arterial line cannulation. Despite prompt resuscitation measures, including the administration of catecholamines and the application of extracoporeal membrane oxygenation, he eventually died. Anesthesiologists need to understand this fulminant disease because extensive debridement under general anesthesia is essential for the treatment of abdominal gas gangrene.
