腹腔鏡下手術で血圧測定不能となった後腹膜出血の２症例

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  • Two Cases of Circulatory Collapse due to Retroperitoneal Vascular Injuries during Laparoscopic Surgery.

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We report two cases of circulatory collapse caused by retroperitoneal hemorrhage due to vascular injuries during laparoscopic surgery.<br>Case 1. A 47-year-old female underwent laparoscopic oophorocystectomy. A sudden circulatory collapse with an abrupt drop in end-tidal CO2 occurred during insertion of a trocar. Although clinical signs suggested pulmonary emboli with CO2, the cause of circulatory collapse was an injury to the left common iliac artery. Hypotension was treated successfully by inotropics and blood transfusion. Open laparotomy was performed and a 6, 000ml blood loss was observed.<br>Case 2. A 67-year-old male underwent laparoscopic partial gastrectomy. A sudden circulatory collapse occurred at the T-bar insertion to lift the stomach. Retroperitoneal hemorrhage around the aorta was found under direct vision. Hypotension was treated successfully by inotropics and blood transfusion.<br>In both cases, significant bleeding could not be identified through laparoscopy because blood mainly accumulated in the retroperitoneum.<br>We should take notice of retroperitoneal hemorrhage as a cause of circulatory collapse during laparoscopic surgery.

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