title: [A case of ligating both upper and anomalous lower left pulmonary veins in the left upper lobectomy].
abstract: A 53-year-old male was anesthetized for left upper lobectomy under one-lung ventilation using a double-lumen endobronchial tube in the lateral position. When the upper left pulmonary vein was ligated, Pao2/FIo2 ratio (PF ratio) was elevated despite the one-lung ventilation. After the operation, the patient was repositioned onto spine position and massive bleeding occurred from the anomalous lower left pulmonary vein, which was ligated during the operation. The lower left pulmonary vein was restored and the bleeding stopped. Because the pulmonary shunt flow from the lower left pulmonary vein had stopped, the PF ratio was unusually elevated. We urge anesthesiologists to pay attention to the arterial blood gas data even when it is better than expected.
authors.affiliation: Department of Anesthesia, Kure Kyousai Hospital, Kure 737-8505.
authors.forename: Masami
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Sato
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanba
authors.forename: Rie
authors.initials: R
authors.lastname: Suzuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Kawanishi
authors.forename: Kanae
authors.initials: K
authors.lastname: Abo
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.forename: Kosuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Mineo
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000768:Anesthesia, General; D001784:Blood Gas Analysis; D002276:Carcinoid Tumor / Q000601:surgery; D006801:Humans; D008026:Ligation / Q000379:methods; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery*