Keywords
asystole, laparoscopy, appendectomy, arrhythmia, cardiac arrest
Disciplines
Cardiology
Abstract
Laparoscopic surgery has become the mainstay of treatment for uncomplicated appendicitis cases. We describe a case of a 29 year old male with a pertinent past medical history of poorly controlled hypertension who was undergoing a routine laparoscopic appendectomy for confirmed appendicitis and developed bradycardia and subsequent asystolic cardiac arrest approximately one hour into the operation. Urgent cardiopulmonary resuscitation and intravenous (IV) atropine were required to reinitiate sinus cardiac rhythm. While the patient was admitted to the intensive care unit for close monitoring following his operation, he ultimately had an uncomplicated postoperative period and an unremarkable cardiac work up and was consequently discharged the day after his procedure. Numerous causes of cardiovascular collapse during laparoscopic procedures have been discussed in the literature including mechanical obstruction of the vagal nerve, high intraabdominal pressures and gas embolism.
