[A case of multiple organ dysfunction following postoperative epididymitis].
We report a case of multiple organ dysfunction following epididymitis. A 53-year-old male patient was admitted to our emergency room with bilateral clavicular fractures, multiple costal fractures and left hemopneumothorax due to a traffic accident. Open reduction of the right clavicular fracture was performed under general anesthesia on the sixth hospital day. A bladder balloon catheter was inserted after induction of anesthesia. The clinical course in the perioperative period was satisfactory and the bladder balloon catheter was removed on the seventh hospital day. However, spontaneous left scrotal pain with tenderness, intense heat with swelling developing on the tenth hospital day, and hypotension, dyspnea and oliguria were noted on the eleventh hospital day. Blood chemistry data showed severe inflammatory findings. Chest X-ray showed acute respiratory distress syndrome. Blood coagulation data showed pre-disseminated intravascular coagulation. The patient's condition continued to deteriorate and we suspected septic shock due to left epididymitis. Emergent left orchiectomy was performed under local anesthesia on the twelfth hospital day. Postoperatively he recovered rapidly. We consider that multiple organ dysfunction following postoperative epididymitis was caused by cytokines released due to systemic inflammatory response syndrome (SIRS) after the trauma, operation, and placement of the bladder catheter. In conclusion, it is important to note that patients with SIRS should undergo further examinations of septic shock immediately and resection of the causative tissue should be performed as soon as possible.
Mizuno
Ju
J
Department of Anesthesia, Kochi Prefectural Aki Hospital, Aki 784-0027.
Sugimoto
Seiji
S
Ohmori
Takao
T
Itadera
Eichi
E
Ichikawa
Norikazu
N
Iiyama
Tatsuo
T
Watanabe
Hironobu
H
Machida
Kenichi
K
D000063:Accidents, Traffic; D004823:Epididymitis / Q000150:complications* / Q000601:surgery; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D009104:Multiple Trauma / Q000601:surgery; D009919:Orchiectomy; D011183:Postoperative Complications; D012772:Shock, Septic / Q000150:complications*