Cerebral infarction detected after laparoscopic partial hepatectomy: case report

Atsushi Kobayashi; Kazuhiro Shirozu; Yuji Karashima; Katsuyuki Matsushita; Ken Yamaura

doi:10.1186/s40981-019-0301-7

Cerebral infarction detected after laparoscopic partial hepatectomy: case report

Atsushi Kobayashi, Kazuhiro Shirozu, Yuji Karashima, Katsuyuki Matsushita, Ken Yamaura

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Bleeding and carbon dioxide (CO2) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO2 gas embolism during laparoscopic hepatectomy.

CASE PRESENTATION: During liver resection, the end-tidal CO2 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.

Original language	English
Pages (from-to)	82
Journal	JA Clinical Reports
Volume	5
Issue number	1
DOIs	https://doi.org/10.1186/s40981-019-0301-7
Publication status	Published - Dec 12 2019

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title = "Cerebral infarction detected after laparoscopic partial hepatectomy: case report",

abstract = "BACKGROUND: Bleeding and carbon dioxide (CO2) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO2 gas embolism during laparoscopic hepatectomy.CASE PRESENTATION: During liver resection, the end-tidal CO2 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.",

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T1 - Cerebral infarction detected after laparoscopic partial hepatectomy

T2 - case report

AU - Kobayashi, Atsushi

AU - Shirozu, Kazuhiro

AU - Karashima, Yuji

AU - Matsushita, Katsuyuki

AU - Yamaura, Ken

PY - 2019/12/12

Y1 - 2019/12/12

N2 - BACKGROUND: Bleeding and carbon dioxide (CO2) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO2 gas embolism during laparoscopic hepatectomy.CASE PRESENTATION: During liver resection, the end-tidal CO2 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.

AB - BACKGROUND: Bleeding and carbon dioxide (CO2) gas embolism have been reported as serious complications associated with laparoscopic surgery. We present a case of cerebral infarction presumably caused by CO2 gas embolism during laparoscopic hepatectomy.CASE PRESENTATION: During liver resection, the end-tidal CO2 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.

U2 - 10.1186/s40981-019-0301-7

DO - 10.1186/s40981-019-0301-7

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SN - 2363-9024

VL - 5

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JO - JA Clinical Reports

JF - JA Clinical Reports

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Cerebral infarction detected after laparoscopic partial hepatectomy: case report

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