Reperfusion pulmonary edema after the removal of hepatocellular carcinoma embolus.

Yonsei Medical Journal
Jae-Min LeeEun-Sung Kim

Abstract

To report a non-fatal case of reperfusion pulmonary edema (RPE) after the removal of a hepatocellular carcinoma embolus, which had caused an acute obstruction of the tricuspid valve and pulmonary vasculature during a hepatic lobectomy. Pulmonary embolism caused by hepatocellular carcinoma embolus is extremely rare, and, in the present case, it was associated with unusual clinical features. A 69-year-old ASA II woman with hepatocellular carcinoma was presented for an elective left hepatic lobectomy. During the surgery, the tumor embolus was dislodged from the interior of the lumen of the inferior vena cava (IVC), which then drifted into the tricuspid valve area and pulmonary vasculature. The patient showed the specific signs of acute pulmonary embolism, such as a reduction in end-tidal carbon dioxide, an increase in central venous pressure, and a decrease in arterial pressure. The patient exhibited the symptoms for about 10 minutes. After this period, however, cardiovascular variables became relatively stable, even during a mechanical obstruction due to cross-clamping the pulmonary artery for embolectomy. After several hours of pulmonary embolectomy, the patient experienced an episode of RPE. The ventilatory supports for the tre...Continue Reading

References

May 17, 1992·The New England Journal of Medicine·J L CarsonT E Hobbins
Nov 1, 1989·The American Review of Respiratory Disease·M J HorganA B Malik
Apr 1, 1986·British Journal of Anaesthesia·C J WilkinsonT Uejima
Jan 10, 2002·Anesthesiology Clinics of North America·L M Capan, S M Miller
Jul 23, 2003·Anesthesia and Analgesia·Greg Stratmann, George A Gregory

❮ Previous
Next ❯

Citations

Dec 25, 2008·Yonsei Medical Journal·Sak LeeByung-Chul Chang

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Related Concepts

Related Feeds

Carcinoma, Hepatocellular

Hepatocellular Carcinoma is a malignant cancer in liver epithelial cells. Discover the latest research on Hepatocellular Carcinoma here.