Lazarevski, Martin and Delipetrova, Natali and Eftimova, Biljana (2024) Anesthesia for splenectomy – case report. In: VII Macedonian congress of anaesthesiology, reanimation and intensive care medicine, 04-07 Apr 2024, Ohrid, N. Macedonia.
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Abstract
Aim - The development and availability of diagnostic and therapeutic procedures allow greater safety in patients
undergoing high-risk surgery. Splenectomy is surgical intervention with potential complications related with bleeding and impaired coagulation. The purpose of this paper is to show that the appropriate and the individual preoperative assessment of the patient, as well as involvement of multidisciplinary team in the process of entire treatment is very important to reduce the complications of this type of surgery.
Materials and methods – Case of 47 years old woman, admitted to hospital with palpable large abdominal mass, loss of weight in last 2-3 months and thrombocytopenia. On CT scan of abdomen was detected splenomegaly, with extremely large dimensions of the spleen. Laboratory tests were performed, revealed pancytopenia and reduced aggregation of platelets. A hematologist was consulted and on bone marrow biopsy, lymphoproliferative disease was not detected. Spleen biopsy was rejected, because of thrombocytopenia and diagnostic splenectomy was indicated by abdominal surgeon. The patient was prepared for elective surgery within a few days and corticosteroids and tranexamic acid was administered by recommendation of transfusionist. Platelets count was tested every day, but was not raised enough. The surgery was performed in general anesthesia, using midazolam, propofol, remifentanil
and sevoflurane. During the surgery, patient was with stable blood pressure and heart rate. After spleen removal, thrombocyte mass was transfused. In postoperative period, the patient was treated for three days in intensive care unit and after platelets count increased and hemostatic test were normal, the treatment was continued on digestive
surgery department.
Conclusion - This type of surgical procedure requires adequate preoperative assessment and anesthesia for better outcome. If potential complications are predicted and treated promptly, the risk of this type of surgery can be significantly reduced.
Key words: splenomegaly, splenectomy, thrombocytopenia, bleeding, coagulopathy.
| Item Type: | Conference or Workshop Item (Poster) |
|---|---|
| Subjects: | Medical and Health Sciences > Clinical medicine |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Assoc.Prof Biljana Eftimova |
| Date Deposited: | 26 Aug 2024 07:26 |
| Last Modified: | 26 Aug 2024 07:26 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/34473 |
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