Transesophageal echocardiography-related massive gastrointestinal bleeding during cardiac surgery

Bae Hyeun Joon; 김경미; Kim Dongho; Chin Ji-Hyun; Choi In-Cheol

doi:10.30579/mbse.2022.5.1.22

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자료유형: 학술저널

저자정보: Bae Hyeun Joon (Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of M) 김경미 (Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of M) Kim Dongho (Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of M) Chin Ji-Hyun (Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of M) Choi In-Cheol (Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of M)

저널정보: 조선대학교 의학연구원 Medical Biological Science and Engineering Medical Biological Science and Engineering Vol.5 No.1

발행연도: 2022.1

수록면: 22 - 26 (5page)

DOI: 10.30579/mbse.2022.5.1.22

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Transesophageal echocardiography (TEE) has become a standard intraoperative monitor during cardiac surgery. Although generally considered safe, some cases of major TEE-related compli cations have been reported. We present a case of a 71-year-old man with aortic aneurysm and aortic regurgitation scheduled for total arch replacement and aortic valve replacement. During the cardiopulmonary bypass period, massive gastric bleeding occurred. Emergency esophago gastroduodenoscopy (EGD) was performed during surgery and a 2-cm deep laceration was ob served at the gastroesophageal junction, suggesting Mallory-Weiss syndrome caused by TEE. Since it was impossible to control massive bleeding using EGD, Sengstaken-Blakemore tube was inserted through the stomach to compress the bleeding site. Massive gastric bleeding was controlled after reversal of the effect of heparin. Since TEE might cause complications, anes thesiologists should manipulate the TEE probe gently with caution. If massive gastric bleeding is suspected during surgery, immediate EGD should be considered for diagnosis and further man agement.

#Transesophageal echocardiography #Cardiac surgery #Gastric bleeding #Mallory-Weiss syndrome #Sengstaken-Blakemore tube

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