Rhabdomyolysis During Laparoscopic Hepatic Subsegmentectomy

Pyeong Hoo Park, MD, Daelim Jee, MD

Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, South Korea (both authors).

ABSTRACTIntroduction: Rhabdomyolysis is very rare in laparoscopic partial resection surgery of the liver. The muscles of the buttock, shoulder girdles, or back are usually injured with the patient in the supine position.

Case Description: We present a case showing peaked T waves and widened QRS complexes in electro-cardiograph that occurred 2 hours after the beginning of laparoscopic hepatic subsegmentectomy for hepatocellular carcinoma. Hyperkalemia and myoglobinemia quickly confirmed rhabdomyolysis during surgery, whereas postoperative creatine phosphokinase levels were normal. Postoperative evaluation suggested that the muscles of the right forearm were affected.

Discussion: The process of rhabdomyolysis appeared to begin early and unexpectedly in the muscles of the right forearm. An elevation of serum myoglobin levels without elevation of creatine phosphokinase levels suggests that serum myoglobin appears to have a crucial role in the diagnosis of early-phase rhabdomyolysis during surgery.

Key Words: Rhabdomyolysis, Laparoscopic surgery, Segmentectomy, Liver.

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