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Hypotension due to compression of the inferior vena cava by intrathoracic herniation of peritoneal fat during laparoscopic surgery - A case report -
Anesth Pain Med 2018;13(1):72-6
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Mijung Yun, Gunn Hee Kim , Seung Young Lee, Hana Cho, Byung Uk Kim, Min Seok Koo, and Mi-Young Kwon
Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea
Correspondence to: Gunn Hee Kim, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea
Tel: 82-2-2260-7114
Fax: 82-2-2267-8685
Received May 26, 2017; Revised July 12, 2017; Accepted July 13, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Vena cava syndrome is caused by central venous obstruction and can be divided into superior vena cava syndrome and inferior vena cava (IVC) syndrome. Symptoms and signs of IVC syndrome vary from no symptoms to lower limb edema, hypotension, and typical venous stasis changes of the lower extremities, such as brownish discoloration of the skin, woody edema, and ulceration. Carbon dioxide pneumoperitoneum, lithotomy-Trendelenburg position, and abdominal obesity could increase intra-abdominal pressure. We report a patient undergoing laparoscopic surgery who showed intrathoracic herniation of peritoneal fat induced by elevated intra-abdominal pressure due to the reasons mentioned above, resulting in IVC syndrome and hypotension perioperatively. The patient was treated with a conservative approach because he was asymptomatic except for hypotension on the first postoperative day.
Key Words : Inferior vena cava, Laparoscopy.

January 2018, 13 (1)
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