eFAST for the diagnosis of a perioperative complication during percutaneous nephrolithotomy.

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
{"title":"eFAST for the diagnosis of a perioperative complication during percutaneous nephrolithotomy.","authors":"Achyut Sharma,&nbsp;Prajjwal Bhattarai,&nbsp;Apurb Sharma","doi":"10.1186/s13089-018-0088-1","DOIUrl":null,"url":null,"abstract":"<p><p>A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined. Fluid collection was seen in Morison's pouch which was drained by the urologist under real-time ultrasonography guidance by anesthesiologist. Distension of abdomen subsequently subsided and patient had normal vitals. Trachea was extubated and patient shifted to post-operative ward. eFAST and FAST scans are routine procedures in the rapid assessment of trauma victims in emergency settings. The fluid extravasation during a routine PCNL procedure may lead to abdominal compartment syndrome. This case demonstrated that use of eFAST rapidly detected abdominal collection and ruled out life-threatening conditions such as hemothorax and pneumothorax and prevented abdominal compartment syndrome. Our case is only an example that potentially lethal conditions like these may be encountered in the perioperative setting and the knowledge of eFAST scan may be of great help.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2018-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-018-0088-1","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Ultrasound Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13089-018-0088-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 4

Abstract

A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined. Fluid collection was seen in Morison's pouch which was drained by the urologist under real-time ultrasonography guidance by anesthesiologist. Distension of abdomen subsequently subsided and patient had normal vitals. Trachea was extubated and patient shifted to post-operative ward. eFAST and FAST scans are routine procedures in the rapid assessment of trauma victims in emergency settings. The fluid extravasation during a routine PCNL procedure may lead to abdominal compartment syndrome. This case demonstrated that use of eFAST rapidly detected abdominal collection and ruled out life-threatening conditions such as hemothorax and pneumothorax and prevented abdominal compartment syndrome. Our case is only an example that potentially lethal conditions like these may be encountered in the perioperative setting and the knowledge of eFAST scan may be of great help.

经皮肾镜取石术围手术期并发症的快速诊断。
患者29岁,麻醉前评估正常,计划行经皮肾镜取石术(PCNL)治疗右侧肾结石合并右侧肾盂结石。手术在全身麻醉下进行,气管内插管,肌肉放松。手术结束时,患者翻身仰卧位,腹部紧张。采用创伤超声(eFAST)立即扩展集中评估,对腹部左右象限(包括心包和耻骨上区域)、左右胸廓和双肺基进行检查。在麻醉师的实时超声指导下,泌尿科医生在Morison袋内排出液体。腹部肿胀随后消退,患者生命体征正常。拔管后转至术后病房。快速和快速扫描是在紧急情况下快速评估创伤受害者的常规程序。常规PCNL手术中液体外渗可导致腹膜间室综合征。本病例表明,使用eFAST可以快速检测腹部收集,排除危及生命的情况,如血胸和气胸,并预防腹部隔室综合征。我们的病例只是围手术期可能遇到的潜在致命情况的一个例子,了解快速扫描可能会有很大的帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
0.00%
发文量
0
审稿时长
13 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信