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European Surgery
Erschienen in:

01.12.2013 | Case Report

Intraoperative pharmacologic increase of systemic blood pressure to detect the source of hemorrhage in thyroid surgery and reoperation: a case report

verfasst von: K. Tonninger-Bahadori, C. Bures, H. T. Zipko, T. Klatte, M. Hermann

Erschienen in: European Surgery | Ausgabe 6/2013

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Summary Background Case report Conclusion

In reoperation for hemorrhage after thyroid surgery, the source of bleeding is frequently undetectable.
We report on a 70-year-old woman who required reoperation for postoperative hemorrhage after thyroidectomy for benign multinodular goiter. During the primary operation, one branch of the upper pole artery was cut accidentally and subsequently coagulated. No further bleeding was noted. During the operation, the patient was mainly hypotensive with a mean systolic blood pressure of 95 mmHg. In the recovery room, bleeding was noted after the blood pressure increased. During the reoperation, bleeding from the arterial upper pole stump was only identified after the blood pressure was increased by systemic administration of phenylephrine and etilefrine.
Pharmacological increase of systemic blood pressure can assist to identify sources of bleeding and may prevent postoperative hemorrhage.
Vorheriger Artikel Pyoderma gangrenosum after ventral hernia repair: a pitfall and how to avoid it
Nächster Artikel The 125-year anniversary of the first sphincter-saving resection of a rectal cancer by Julius von Hochenegg in Vienna
Literatur
1.
Promberger R, J O, Kober F, et al. Risk factors for postoperative bleeding after thyroid surgery. Br J Surg. 2012;99:373–9.PubMedCrossRef
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Agarwal A, Mishra SK. Post-thyroidectomy haemorrhage: an analysis of critical factors in successful management. J Indian Med Assoc. 1997;95:418–9,433.PubMed
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Burkey SH, van Heerden JA, Thompson GB, Grant CS, Schleck CD, Farley DR. Reexploration for symptomatic hematomas after cervical exploration. Surgery. 2001;130:914–20.PubMedCrossRef
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Chiang FY, Lin JC, Wu CW, et al. Morbidity after total thyroidectomy for benign thyroid disease: comparison of Graves’ disease and non-Graves’ disease. Kaohsiung J Med Sci. 2006;22:554–9.PubMedCrossRef
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Leyre P, Desurmont T, Lacoste L, et al. Does the risk of compressive hematoma after thyroidectomy authorize 1-day surgery? Langenbecks Arch Surg. 2008;393:733–7.PubMedCrossRef
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Ozbas S, Kocak S, Aydintug S, Cakmak A, Demirkiran MA, Wishart GC. Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goitre. Endocr J. 2005;52:199–205.PubMedCrossRef
Metadaten
Titel
Intraoperative pharmacologic increase of systemic blood pressure to detect the source of hemorrhage in thyroid surgery and reoperation: a case report
verfasst von
K. Tonninger-Bahadori
C. Bures
H. T. Zipko
T. Klatte
M. Hermann
Publikationsdatum
01.12.2013
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2013
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-013-0235-7

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