Abstract
Intraoperative pulmonary tumor embolism occurred during right hepatectomy for primary hepatic carcinoma. The tumor embolus produced abrupt arterial hypotension, tachycardia, an increased central venous pressure, intense cyanosis, followed by cardiac arrest. Pulmonary tumor embolism resulting from hepatic tumors is rare and has not been reported to have occurred intraoperatively. When tumor thrombosis has been detected or suspected, hepatic vascular exclusion should be considered for the prevention of intraoperative embolism.
Résumé
Les auteurs rapportent un cas d’embolie pulmonaire tumorale per-opératoire lors d’un hépatectomie pour hépatome. L’accident est révélé par une hypotension artérielle brutale avec une tachycardie, une augmentation de la pression veineuse centrale jusqu’à 2.5 kPa (25 cm H2O), une cyanose intense et est suivi par un arrêt circulatoire.
Les embolies pulmonaires tumorales sont rares et cette cause d’arrêt circulatoire per-opératoire n’a jamais été signalée. Lorsqu’une thrombose tumorale est dépistée ou suspectée au cours du bilan pré-opératoirê, l’acte chirurgical doit en tenir compte et prévoir une exclusion vasculaire totale.
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Blanlœil, Y., Paineau, J., Vissett, J. et al. Intraoperative pulmonary tumor embolism after hepatectomy for liver carcinoma. Can Anaesth Soc J 30, 69–71 (1983). https://doi.org/10.1007/BF03007719
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DOI: https://doi.org/10.1007/BF03007719