CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by St-Pierre, J.
Right arrow Articles by Hebert, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by St-Pierre, J.
Right arrow Articles by Hebert, Y.

Canadian Journal of Anesthesia, Vol 45, 1196-1199, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Massive gastrointestinal hemorrhage after transoesophageal echocardiography probe insertion

J St-Pierre, LP Fortier, P Couture and Y Hebert
Department of Anaesthesia and Cardiac Surgery, Montreal Heart Institute, Quebec, Canada.

PURPOSE: To describe a case of a massive gastric bleeding following emergency coronary artery bypass surgery associated with transoesophageal echocardiographic (TEE) examination. CLINICAL FEATURES: A 50-yr-old man was referred for an acute myocardial infarction and pulmonary edema (Killip class 3). Twelve hours after his myocardial infarction, he was still having chest pain despite an i.v. heparin infusion. Coronary angiography revealed severe three-vessel disease with multifocal stenosis of the left anterior descending, circumflex and total occlusion of the right coronary artery. The patient was transferred to the operating room for emergency coronary artery bypass graft surgery. After total systemic heparinization (3 mg.kg-1) was obtained for cardiopulmonary bypass, a multiplane TEE probe was inserted without difficulty to monitor myocardial contractility during weaning from CPB. During sternal closure, the TEE probe was removed and an orogastric tube was inserted with immediate drainage of 1,200 ml red blood. Endoscopic examination demonstrated a mucosal tear near the gastro-oesophageal junction and multiple erosions were seen in the oesophagus. These lesions were successfully treated with submucosal epinephrine injections and the patient was discharged from the hospital eight days after surgery. CONCLUSION: This is a report of severe gastrointestinal hemorrhage following TEE examination in a fully heparinized patient. This incident suggest that, if the use of TEE is expected, the probe should preferably be inserted before the administration of heparin and the beginning of CPB.


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
M. E. McSweeney, S. Garwood, J. Levin, M. R. Marino, S. X. Wang, D. Kardatzke, D. T. Mangano, and R. L. Wolman
Adverse Gastrointestinal Complications After Cardiopulmonary Bypass: Can Outcome Be Predicted from Preoperative Risk Factors?
Anesth. Analg., June 1, 2004; 98(6): 1610 - 1617.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
P. Zimmermann, C. Greim, H. Trautner, U. Sagmeister, K. Kraemer, and N. Roewer
Echocardiographic Monitoring During Induction of General Anesthesia with a Miniaturized Esophageal Probe
Anesth. Analg., January 1, 2003; 96(1): 21 - 27.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1998 by the Canadian Anesthesiologists' Society.