[A superior vena cava syndrome due to a surgical retractor].
A 56-year-old male diagnosed of epidermoid carcinoma of the right lung (T4 N0 M0, stage IIIb) is described. He had earlier received chemotherapy and radiotherapy and was scheduled for removal of the right lung. During surgery the need to resect tumor infiltration of the right atrium became evident. During weaning from by-pass sudden deterioration of hemodynamics occurred with poor response to volume and inotropic drugs. Superior vena cava syndrome due to traction of the innominate trunk from a surgical retractor was diagnosed; the crisis resolved when the retractor was withdrawn. We discuss the pathophysiology of this clinical picture and relevant intraoperative aspects.
Fernández-Liesa
J I
JI
Departamento de Anestesiología, Reanimación y Terapéutica del dolor, Hospital García Orcoyen, Estella, Navarra. jiferlie@mixmail.com
Calderón
R
R
Fidalgo
I
I
Arrondo
J
J
Panadero
A
A
Mendieta
J M
JM
D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000295:instrumentation; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology*; D013525:Surgical Instruments / Q000009:adverse effects*
Síndrome de vena cava superior por retractor quirúrgico.