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Management of Pulmonary Thromboembolism with Inferior Vena Cava Filter: A Case Report
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Yeon Jang, Yun Sun Chin, Hyun Suk Jung, Ho Kyung Song
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Korean J Crit Care Med. 2008;23(2):111-114.
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DOI: https://doi.org/10.4266/kjccm.2008.23.2.111
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- We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.
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A Case of Rupture of Right Common Iliac Artery and Vein during Lumbar Discectomy: A case report
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Yeon Jang, Seung Eun Ji, Eun Jung Cho, Soo Seog Park, Soo Young Jung, Ho Kyung Song
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Korean J Crit Care Med. 1997;12(2):159-162.
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- Intraabdominal vascular complications associated with lumbar disc surgery are rare but have potentially fatal consequences. Clinical manifestations of such injuries may be extremely variable and confused with anesthetic complications, myocardial infarction, or pulmonary embolism.
So, the presence of vascular injury may not be recognized immediately. Recently, we experienced a case of extensive retroperitoneal hemorrhage during lumbar disc surgery. The patient was a 35 year-old healthy female. During operation, unexplained profound hypotension and tachycardia developed, but abnormal bleeding was not seen in the operative wound.
Emergency CT of the abdomen was performed, and huge retroperitoneal hematoma was confirmed by the CT scan.
Immediate abdominal exploration revealed the injury to right common iliac artery and vein. The patient underwent primary repair of lacerated artery and vein. Postoperative recovery was uneventful. We think awareness of the likelihood of vascular complications related to disc surgery is quite important for early diagnosis and management of these life-threatening complications.
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Malignant Hyperthermia during General Anesthesia: Two cases
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Eun Chung Cho, Eun Sung Kim, Young Ho Hong, Yeon Jang, Soo Seok Park
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Korean J Crit Care Med. 1997;12(1):89-94.
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- Malignant hyperthermia is a hypermetabolic disorder of skelectal muscle. It goes fatal progress in the majority of cases unless early diagnosis and treatment are performed. We experienced two cases of malignant hyperthermia during general anesthesia. First case is 7-year-old boy with congenital bilateral ptosis. Second case is 46-year-old male with lung cancer. We were faced to difficult intubation due to masseter muscle spasm. After induction, tachycardia, muscle rigidity, body temperature elevation, end tidal CO2 elevation and acidosis developed. Enflurane was discontinued, vigorous emergency treatment was attempted.
Fortunately, two patients were recovered from malignant hyperthermia and then discharged without complications.
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KSCCM
