A Rare Cause of Postoperative Hypotension

摘要: A 62-year-old woman presented with a 3-month history of abdominal distension and decreased exercise tolerance. chest radiograph showed probable left pleural effusion (Fig 1). CT scan the abdomen revealed solid ovarian mass omental caking large volume ascites; there was also confirmation effusion. Three days before surgery pulmonary angiogram (CTPA) no evidence thromboembolism (PTE). The patient had some improvement in her symptoms after paracentesis thoracentesis drainage 2,000 mL 250 fluid, respectively. She underwent total hysterectomy, bilateral oophorectomy, partial sigmoid resection an estimated blood loss 850 mL. During operation, she received 5 L crystalloid required phenylephrine at 40 to 80 μg/min maintain mean arterial pressure > 65 mm Hg. extubated surgery, but immediately extubation, became markedly hypotensive hypoxemic BP 50/20 Hg oxygen saturation 70%. An ECG T-wave inversions from V1 V5 S1Q3T3 pattern 2). bedside echocardiogram enlarged right ventricle (RV), septal dyskinesia, obliteration ventricle, all consistent systolic diastolic RV overload 3).