A Surgical Case of Multiple System Atrophy with Propofol Infusion Syndrome

Abstract

The patient was a 56-year-old man with multiple system atrophy who was referred to our hospital for gastrostomy. Endoscopic gastrostomy was not possible due to the presence of a segment of the intestine between the stomach and abdominal wall, necessitating gastrostomy under general anesthesia. There were no significant findings on preoperative examination. We performed gastrostomy in the anterior wall of the lower gastric body via laparotomy. No abnormal findings were found in the abdominal cavity, and there were no changes in the blood pressure or body temperature during the operation. His general condition was stable, but blood biochemical examination showed abnormally elevated levels of AST/ALT (1929/1771 IU/l), LDH (1559 IU/l), and CPK (1413 IU/l) on postoperative day 1. Abdominal CT showed no significant abnormalities, and the patient was discharged from the hospital on postoperative day 5. In this case, it was concluded that the liver dysfunction and hyperCPKemia were caused by the immediate reaction of rhabdomyolysis as part of the propofol injection syndrome.