Delayed recovery following laparoscopic partial hepatectomy

Eur J Anaesthesiol. 2012 Feb;29(2):105-7. doi: 10.1097/EJA.0b013e32834c149f.

Abstract

We present a 42-year-old woman with unexpected coma after laparoscopic partial hepatectomy. MRI demonstrated ischaemic cerebral lesions. Further investigation revealed a patent foramen ovale. Cryptogenic stroke arising from a paradoxical carbon dioxide embolism was diagnosed. After 5 days of intensive care, she made a near complete recovery. Perioperative stroke, paradoxical emboli during surgery, patent foramen ovale, carbon dioxide cerebral embolism and therapeutic strategies are discussed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carbon Dioxide / adverse effects
  • Coma / etiology
  • Critical Care
  • Embolism, Air / diagnosis
  • Embolism, Air / etiology
  • Embolism, Paradoxical / diagnosis
  • Embolism, Paradoxical / etiology*
  • Female
  • Foramen Ovale, Patent / complications
  • Foramen Ovale, Patent / diagnosis
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • Humans
  • Intracranial Embolism / diagnosis
  • Intracranial Embolism / etiology*
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Magnetic Resonance Imaging
  • Stroke / diagnosis
  • Stroke / etiology

Substances

  • Carbon Dioxide