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ACC : Acute and Critical Care



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HOME > Acute Crit Care > Volume 27(2); 2012 > Article
Case Report Usability of Esophageal Doppler for Monitoring of Concealed Retroperitoneal Hemorrhage during Laparoscopy Assisted Subtotal Gastrectomy
Sung Ha Mun, Seung Hwan Lee, Min Young No

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Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.

Hemodynamic monitoring is an essential element in the management of perioperative patients. In addition, anesthesiologists routinely used blood pressure (invasive or non invasive), heart rate, urinary output and central venous pressure as monitoring modalities. Esophageal doppler monitoring, as a minimally invasive hemodynamic assessment tool, has a good correlation with pulmonary artery catheterization in measuring cardiac output. We experienced a case of concealed retroperitoneal hemorrhage in a patient who underwent a laparoscopic subtotal gastrectomy. When surgeons tried to close trocar sites, the patient's blood pressure dropped rapidly. At laparoscopy, we could not find gross bleeding. However, we could detect hypovolemia by esophageal doppler monitoring (CardioQ, Deltex(TM), UK). The procedure was converted to open laparotomy. Thereafter, we could find retroperitoneal hemorrhage, and vascular repair was done successfully. The patient recovered without any other complications.

ACC : Acute and Critical Care