| Item type |
学術雑誌論文 / Journal Article_02(1) |
| 公開日 |
2018-06-11 |
| タイトル |
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タイトル |
Cerebral Infarction by Paradoxical Gas Embolism During Laparoscopic Liver Resection with Injury of the Hepatic Vessels in a Patient without a Right-to-Left Systemic Shunt. |
| 言語 |
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言語 |
eng |
| 資源タイプ |
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資源タイプ |
journal article |
| 著者 |
川原, 敏靖
萩原, 正弘
髙橋, 裕之
田中, 茉里子
今井, 浩二
澤田, 潤
国沢, 卓之
古川, 博之
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| 著者 ローマ字 |
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Kawahara, Toshiyasu |
| 著者 ローマ字 |
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Hagiwara, Masahiro |
| 著者 ローマ字 |
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Takahashi, Hiroyuki |
| 著者 ローマ字 |
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Tanaka, Mariko |
| 著者 ローマ字 |
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Imai, Koji |
| 著者 ローマ字 |
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Sawada, Jun |
| 著者 ローマ字 |
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Kunisawa, Takayuki |
| 著者 ローマ字 |
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Furukawa, Hiroyuki |
| 書誌情報 |
The American journal of case reports
巻 18,
p. 687-691,
発行日 2017-06-01
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| ISSN |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
1941-5923 |
| DOI |
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関連タイプ |
isIdenticalTo |
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識別子タイプ |
DOI |
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関連識別子 |
10.12659/AJCR.903777 |
| 識別番号 その他 |
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内容記述タイプ |
Other |
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内容記述 |
PMID：28630395 |
| 抄録 |
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内容記述タイプ |
Abstract |
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内容記述 |
BACKGROUND Carbon dioxide (CO2) is believed to be the safest gas for laparoscopic surgery, which is a standard procedure. We experienced severe cerebral infarction caused by paradoxical CO2 embolism during laparoscopic liver resection with injury of the hepatic vessels despite the absence of a right-to-left systemic shunt. CASE REPORT A 60-year-old man was diagnosed with hepatocellular carcinoma in the right hepatic lobe secondary to alcoholic liver disease. We planned the laparoscopy-assisted liver resection. During the surgery, the root of the right hepatic vein was injured. A 1.5-cm hole was accidentally made in the right hepatic vein, while mobilizing the right hepatic lobe laparoscopically. End-tidal CO2 dropped from 39 to 15.5 mmHg, and systemic blood pressure dropped from 121 to 45 mmHg, returning to normal with the administration of inotropes. The transesophageal echocardiography revealed numerous bubbles in the left atrium and ventricle. The Bispectral Index monitoring system showed low brain activity, suggesting cerebral infarction due to paradoxical gas embolism. The hepatectomy was completed by conversion to open laparotomy. The patient went into a coma and suffered quadriplegia after surgery, despite the cooling of his head and the administration of Thiamylal. Brain MRI revealed cerebral infarction in the broad area of the cerebral cortex right side predominantly, with poor blood flow confirmed by the brain perfusion single-photon emission CT. Rehabilitation was gradually achieved with Botox injections. CONCLUSIONS Cerebral infarction by paradoxical gas embolism is a rare complication in laparoscopic surgery, but it is important to be aware of the risk and to be prepared to treat it. |
| 注記 |
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内容記述タイプ |
Other |
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注記 |
This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) |
| 資源タイプ |
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内容記述タイプ |
Other |
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資源タイプ |
text |
| 著者版フラグ |
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出版タイプ |
VoR |
| フォーマット |
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内容記述タイプ |
Other |
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内容記述 |
application/pdf |
| ID(XooNIps) |
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28630395 |
| 閲覧数(XooNIps) |
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| ダウンロード数(XooNIps) |
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835 |
7014.pdf (222.9 kB)
