A case of shock due to compression of the right atrium by the liver after postoperative bleeding

doi:N/A

eISSN: None / ISSN: None

Netharland Journal of Critical Care

2019, Volume 27, Issue 4 : 159-161

Article

A case of shock due to compression of the right atrium by the liver after postoperative bleeding

Leuverink T.H.W.

Nolte C.M.H.

van Delden O.M.

Tepaske R.

⁴

Busch O.R.

⁵

Department of Anaesthesiology, Amsterdam UMC location AMC, Amsterdam, Netherlands

Department of Intensive Care, Amsterdam UMC Location AMC, Amsterdam, Netherlands

Department of Interventional Radiology, Amsterdam UMC Location AMC, Amsterdam, Netherlands

⁴

Department of Surgery, Amsterdam UMC Location AMC, Amsterdam, Netherlands

⁵

Department of Anaesthesiology, Netherlands Cancer Institute, Amsterdam, Netherlands

Abstract

This report describes the case of a 36-year-old woman who presented to our intensive care unit in profound refractory shock after a complicated laparoscopic cholecystectomy. Transoesophageal echocardiography showed an extrapericardial mass blocking venous return and computed tomography showed an intra-abdominal haematoma with displacement of the liver. The patient was diagnosed with extrapericardial tamponade caused by compression of the right atrium by the liver due to a large intra-abdominal haematoma. Decompression via explorative laparotomy was performed, resulting in a quick and full recovery of the patient. We conclude that extrapericardial tamponade should be considered in patients presenting with refractory shock after abdominal surgery. © 2019, Netherlands Society of Intensive Care. All rights reserved.

Keywords

Extrapericardial tamponade

Laparoscopic cholecystectomy

Obstructive shock

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