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Year : 2001  |  Volume : 47  |  Issue : 3  |  Page : 185-7

Cardiomediastinal tamponade and shock following three-stage transthoracic oesophagectomy.

Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai - 400 012, India., India

Correspondence Address:
V Cherian
Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai - 400 012, India.
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Source of Support: None, Conflict of Interest: None

PMID: 11832620

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Massive gastric tube dilatation causing cardiomediastinal tamponade is an unusual cause of obstructive shock after transthoracic oesophagectomy. A 55-year-old female was operated for total transthoracic oesophagectomy. Twelve hours after the surgery, she developed hypotension and raised central venous pressure unresponsive to fluid infusion and ionotropes. X-ray chest showed a massively dilated stomach, which was causing intrathoracic tamponade. Suction applied to the nasogastric tube led to aspiration of 150-200 ml of fluid and a large volume of air, which led to resolution of the haemodynamic instability. A simple manoeuvre like nasogastric suction in postoperative case of oesophagectomy can serve as a diagnostic as well as therapeutic tool. It must be performed before resorting to invasive and expensive examination or intervention.


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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow