2025 Volume 45 Issue 6 Pages 570-572
A 26-year-old man with severe motor and intellectual disabilities and advanced scoliosis underwent emergency surgery for postoperative intussusception after being diagnosed as having adhesive small bowel obstruction. After the operation, he developed tachycardia triggered by repositioning. Six hours postoperatively, he progressed from tachycardia to cardiac arrest. Despite resuscitative efforts, he was pronounced dead. Although a rapid drop in hemoglobin to 4.1 g/dL indicated massive bleeding, there were no external findings or changes in the drain output to suggest hemorrhage. Autopsy revealed an abdominal wall injury and intraperitoneal hematoma in the left abdominal region. It was presumed that the injury occurred during left lateral repositioning, due to compression from the severely deformed spine. Patients with severe motor and intellectual disabilities differ from healthy individuals in terms of their physiological reserve, general condition, and risk of perioperative complications due to the complex underlying disorders. Surgeons should collaborate closely with pediatricians and remain vigilant for unexpected postoperative events.
