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01.12.2013 | Case Report | Ausgabe 6/2013

European Surgery 6/2013

Intraoperative pharmacologic increase of systemic blood pressure to detect the source of hemorrhage in thyroid surgery and reoperation: a case report

Zeitschrift:
European Surgery > Ausgabe 6/2013
Autoren:
K. Tonninger-Bahadori, C. Bures, H. T. Zipko, T. Klatte, M. Hermann

Summary

Background

In reoperation for hemorrhage after thyroid surgery, the source of bleeding is frequently undetectable.

Case report

We report on a 70-year-old woman who required reoperation for postoperative hemorrhage after thyroidectomy for benign multinodular goiter. During the primary operation, one branch of the upper pole artery was cut accidentally and subsequently coagulated. No further bleeding was noted. During the operation, the patient was mainly hypotensive with a mean systolic blood pressure of 95 mmHg. In the recovery room, bleeding was noted after the blood pressure increased. During the reoperation, bleeding from the arterial upper pole stump was only identified after the blood pressure was increased by systemic administration of phenylephrine and etilefrine.

Conclusion

Pharmacological increase of systemic blood pressure can assist to identify sources of bleeding and may prevent postoperative hemorrhage.

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