Journal of Ultrasound

, Volume 19, Issue 1, pp 47–52 | Cite as

Could transesophageal echocardiography be useful in selected cases during liver surgery resection?

  • Luigi Vetrugno
  • Livia Pompei
  • Ester Zearo
  • Giorgio Della Rocca
Case Report



Although only limited scientific evidence exists promoting the use of transesophageal echocardiography (TEE) in non cardiac surgery, several recent studies have documented its usefulness during liver surgery.

Methods and results

In the present case study, through the use of color Doppler TEE, compression of the inferior vena cava and the right hepatic vein was clearly evident, as was their restoration after surgery.


TEE should be encouraged in patients undergoing liver resection, not only for hemodynamic monitoring, but also for its ability to provide information about the anatomy of the liver, its vessels, and inferior vena cava patency.


Transesophageal echocardiography Liver surgery Hepatic angioma Hemodynamic monitoring 


Il fegato può essere coinvolto da una varietà di patologie, che vanno dalle lesioni benigne come l’angioma epatico, che possono necessitare di essere resecate, all’insufficienza epatica per la quale l’unica terapia possible è il trapianto di fegato. Benchè ci siano solo limitate evidenze scientifiche che supportino l’utilizzo dell’ecografia transesofagea (TEE) nella chirurgia non cardiaca, alcuni studi hanno documentato la sua utilità durante la chirurgia epatica. Nel caso in studio, attraverso l’uso del color Doppler TEE la compressione della vena cava inferiore a della vena epatica destra erano visualizzate così come le loro dimensioni dopo l’intervento chirurgico. Per tale motivo l’utilizzo del TEE dovrebbe essere incoraggiato nei pazienti che vanno incontro a resezione epatica non solo come strumento di valuatzione emodinamica ma anche per la sua abilità di dare informazioni utili sull’anatomia del fegato dei suoi vasi e sulla pervietà della vena cava.


Conflict of interest

Luigi Vetrugno, Livia Pompei, Ester Zearo, Giorgio Della Rocca declare that they have no conflict of interest.

Informed consent

The procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration. The patient provided written informed consent to the inclusion of information in this article that could potentially lead to their identification.

Supplementary material

40477_2014_103_MOESM1_ESM.mp4 (817 kb)
Clip 1: Transesophageal-trans-gastric view at 0° of the angioma and its compression of the inferior vena cava (IVC) and the right hepatic vein (RHV) (MP4 817 kb)
40477_2014_103_MOESM2_ESM.mp4 (3 mb)
Clip 2: Restoration (after surgery) of the inferior vena cava (IVC) and right hepatic vein (RHV) with transesophageal-trans-gastric view at 62° (MP4 3,095 kb)
40477_2014_103_MOESM3_ESM.mp4 (787 kb)
Clip 3: Transesophageal-trans-gastric view at 0° to obtain an image of the right atrium, inferior vena cava (IVC) compression at the confluence of the right hepatic veins (RHV) (MP4 787 kb)


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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2014

Authors and Affiliations

  • Luigi Vetrugno
    • 1
  • Livia Pompei
    • 1
  • Ester Zearo
    • 1
  • Giorgio Della Rocca
    • 1
  1. 1.Department of Anesthesia and Intensive Care MedicineUniversity of UdineUdineItaly

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