Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-46026 | DOI: 10.14744/tjtes.2020.46026  

Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion

Seok Hwa Youn1, Yong Chul Shin2, Jiho Yoon1, Sunyoung Baek1, Younghwan Kim1
1Department of Surgery, National Medical Center, Seoul, Korea
2Department of Thoracic Surgery, National Medical Center, Seoul, Korea

Trauma with prolonged shock can cause systemic capillary leak syndrome regardless of the site of injury and a transfusion can aggravate it. The systemic capillary leak induces both an abdominal compartment syndrome and pulmonary edema, and a transfusion can aggravate these sequelae within hours. In our case, 21-year-old man with a penetrating injury in his left thorax experienced delay in rescue and definitive surgery. To manage life-threatening shock, massive blood transfusion and crystalloids had been infused. Cardiopulmonary cerebral resuscitations were performed two times during the surgery. Massive amount of pulmonary secretions emitted from his airways with severe hypoxia along with development of massive ascites causing abdominal compartment syndrome while the surgery was underway. After temporary abdominal closure, he was moved to the intensive care unit and underwent veno-venous extracorporeal membranous oxygenation. He recovered without any notable complications. It is important to prevent and correct the shock rapidly by appropriate rescue, controlling the source and infusing less amount of crystalloid and tranfusion.

Keywords: capillary leak syndrome, injuries, abdominal compartment syndrome, pulmonary edema, stab




Corresponding Author: Younghwan Kim, South Korea


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