Key result
Unexplained hypotension during a robotic left lower lobectomy in an 82-year-old male was found to be caused by intra-abdominal bleeding from a splenic injury.
Why the study?
Hypotension during thoracic surgery is traditionally attributed to intrathoracic causes, but non-thoracic causes can also occur.
Case Report (n=1)
Anesthesiologists should remain vigilant for non-thoracic causes, such as splenic injury, when encountering unexplained hypotension during left-sided thoracic surgery.
Unexpected hypotension after thoracic surgery may reflect splenic injury; this case leaves open the incidence of non-thoracic sources.
Hypotension during thoracic surgery is traditionally attributed to intrathoracic causes such as pulmonary bleeding, ventilation, causing decreased venous return, and a decrease in myocardial contractility. We present a case of unexplained hypotension presenting at the end of left-sided thoracic surgery. The cause of hypotension was ultimately found to be due to intra-abdominal bleeding from a splenic injury. This case reminds the anesthesiologist to be vigilant of non-thoracic causes of hypotension during left-sided lung surgery.
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Cohen et al. (2019) conducted a case report in Hypotension during thoracic surgery (n=1). Robotic left lower lobectomy was evaluated. Unexplained hypotension during a robotic left lower lobectomy in an 82-year-old male was found to be caused by intra-abdominal bleeding from a splenic injury.
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