Cerebral infarction detected after laparoscopic partial hepatectomy: case report

BACKGROUND: Bleeding and carbon dioxide (CO(2)) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO(2) gas embolism during laparoscopic hepatectomy. CASE PRESENTATION: During liver resection,...

Descripción completa

Detalles Bibliográficos
Autores principales: Kobayashi, Atsushi, Shirozu, Kazuhiro, Karashima, Yuji, Matsushita, Katsuyuki, Yamaura, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966969/
https://www.ncbi.nlm.nih.gov/pubmed/32025949
http://dx.doi.org/10.1186/s40981-019-0301-7
_version_ 1783488854796271616
author Kobayashi, Atsushi
Shirozu, Kazuhiro
Karashima, Yuji
Matsushita, Katsuyuki
Yamaura, Ken
author_facet Kobayashi, Atsushi
Shirozu, Kazuhiro
Karashima, Yuji
Matsushita, Katsuyuki
Yamaura, Ken
author_sort Kobayashi, Atsushi
collection PubMed
description BACKGROUND: Bleeding and carbon dioxide (CO(2)) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO(2) gas embolism during laparoscopic hepatectomy. CASE PRESENTATION: During liver resection, the end-tidal CO(2) suddenly dropped from 40 to 21 mmHg. Simultaneously, ST elevation in lead II and ST depression in lead V5 of the electrocardiogram were observed. After improvement of these electrocardiographic changes, surgery was continued. Postoperatively, incomplete paralysis was present in the right arm and leg. Magnetic resonance imaging revealed cerebral infarction in the broad area of the left cerebral cortex. These complications might have been caused by paradoxical embolism. CONCLUSION: We should always keep in mind the risk of cerebral infarction with neurological deficits in the case of laparoscopic surgery. Careful monitoring and appropriate treatment for gas embolism are necessary during laparoscopic surgery.
format Online
Article
Text
id pubmed-6966969
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-69669692020-02-04 Cerebral infarction detected after laparoscopic partial hepatectomy: case report Kobayashi, Atsushi Shirozu, Kazuhiro Karashima, Yuji Matsushita, Katsuyuki Yamaura, Ken JA Clin Rep Case Report BACKGROUND: Bleeding and carbon dioxide (CO(2)) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO(2) gas embolism during laparoscopic hepatectomy. CASE PRESENTATION: During liver resection, the end-tidal CO(2) suddenly dropped from 40 to 21 mmHg. Simultaneously, ST elevation in lead II and ST depression in lead V5 of the electrocardiogram were observed. After improvement of these electrocardiographic changes, surgery was continued. Postoperatively, incomplete paralysis was present in the right arm and leg. Magnetic resonance imaging revealed cerebral infarction in the broad area of the left cerebral cortex. These complications might have been caused by paradoxical embolism. CONCLUSION: We should always keep in mind the risk of cerebral infarction with neurological deficits in the case of laparoscopic surgery. Careful monitoring and appropriate treatment for gas embolism are necessary during laparoscopic surgery. Springer Berlin Heidelberg 2019-12-12 /pmc/articles/PMC6966969/ /pubmed/32025949 http://dx.doi.org/10.1186/s40981-019-0301-7 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Kobayashi, Atsushi
Shirozu, Kazuhiro
Karashima, Yuji
Matsushita, Katsuyuki
Yamaura, Ken
Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title_full Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title_fullStr Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title_full_unstemmed Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title_short Cerebral infarction detected after laparoscopic partial hepatectomy: case report
title_sort cerebral infarction detected after laparoscopic partial hepatectomy: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966969/
https://www.ncbi.nlm.nih.gov/pubmed/32025949
http://dx.doi.org/10.1186/s40981-019-0301-7
work_keys_str_mv AT kobayashiatsushi cerebralinfarctiondetectedafterlaparoscopicpartialhepatectomycasereport
AT shirozukazuhiro cerebralinfarctiondetectedafterlaparoscopicpartialhepatectomycasereport
AT karashimayuji cerebralinfarctiondetectedafterlaparoscopicpartialhepatectomycasereport
AT matsushitakatsuyuki cerebralinfarctiondetectedafterlaparoscopicpartialhepatectomycasereport
AT yamauraken cerebralinfarctiondetectedafterlaparoscopicpartialhepatectomycasereport

Ejemplares similares