title: Small change in capnography led to the detection of an intravascular thrombus.
abstract: This report highlights the importance of accurate interpretation of even small intraoperative capnography changes. In this case, an otherwise unexplained sudden small decrease in end-expiratory carbon dioxide tension (P(ET)CO2) led to the detection of a deep venous thrombus. During the surgery of a 34-year-old woman with a known carcinoma of the corpus uteri, who was scheduled for paraaortal lymphadenectomy, a sudden decrease in carbon dioxide tension occurred. In careful exploration of the surgical field to rule out a thromboembolic event, the surgeons noticed an induration of the right iliac vein. A consulting vascular surgeon exposed a right-sided, irregular, double-lumen, common iliac vein with a thrombus the tip of which floated in the inferior vena cava. Following complete thrombectomy, the procedure was accomplished without further adverse events.
authors.affiliation: Department of Anesthesiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. hubert.schmitt@kfa.imed.uni-erlangen.de
authors.forename: Hubert J
authors.initials: HJ
authors.lastname: Schmitt
authors.forename: Tim
authors.initials: T
authors.lastname: Beckmann
authors.forename: Werner
authors.initials: W
authors.lastname: Lang
mesh_terms: D000328:Adult; D019296:Capnography; D002245:Carbon Dioxide / Q000032:analysis; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D020246:Venous Thrombosis / Q000175:diagnosis*
chemical_list: D002245:Carbon Dioxide