Cardiovascular Anesthesia
Online ISSN : 1884-7439
Print ISSN : 1342-9132
ISSN-L : 1342-9132
3 cases in which pneumoperitoneum gas flowed into the left heart during laparoscopic liver resection
Kohsuke TsubakiSatoki InoueJunji EgawaYusuke NaitouMitsuru IdaMasahiko Kawaguchi
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2021 Volume 25 Issue 1 Pages 71-74

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Abstract

 We used transesophageal echocardiography (TEE) for intraoperative management of pneumoperitoneum gas embolism because it can occur during laparoscopic hepatectomy. Here, we report the influx of pneumoperitoneum gas into the left heart system in three cases. Case 1 was a 78-year-old man who was planned for post-hepatic segmentectomy. The patient's bubble test was negative. During hepatic transection, an air embolus in the atrium and ventricle was observed. A few minutes later, pneumoperitoneum had to be interrupted because the patient's blood pressure decreased. At that time, we observed the influx of the air embolus into the left heart system. Case 2 was a 76-year-old woman who was planned for partial hepatectomy. The patient's bubble test was positive. A small air embolus was observed during hepatic transection and flowed into the left heart system. Case 3 was a 59-year-old man who was planned for partial hepatectomy. The patient's bubble test was positive. A small air embolus was observed during hepatic transection and flowed into the left heart system. Since an air embolus derived from pneumoperitoneum gas flowing into the left heart system is potentially dangerous, evaluation by TEE may be useful in preventing complications.

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© 2021 Japanese Society of Cardiovascular Anesthesiologists
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