Anesth Pain Med.  2016 Apr;11(2):182-185. 10.17085/apm.2016.11.2.182.

Increased amount of pleural effusion during head-down tilt position in ovarian cancer patient with ascites: A case report

• Shin YM
• An JH
• Lee C
• Park JY
• Ban JS
• Lee SG

• KMID: 2358482
• DOI: http://doi.org/10.17085/apm.2016.11.2.182

Abstract

Pseudo-Meigs syndrome is accompanied with pleural effusion, ascites and a benign or malignant tumor of ovary, tubes, uterus, round ligament or colon. We reported a case of hypoxia in an ovarian cancer patient with moderate ascites after head-down tilt position for central venous catheterization under general anesthesia. Massive pleural effusion was detected on portable chest X-ray, which was not observed in a preoperative radiologic test. The patient had no respiratory symptoms and breath sound was normal in both lungs prior to surgery. The pleural effusion was resolved by a chest tube insertion.

Keyword

Ascites; Head-down tilt; Ovarian neoplasms; Pleural effusion

MeSH Terms

Anesthesia, General
Anoxia
Ascites*
Catheterization, Central Venous
Central Venous Catheters
Chest Tubes
Colon
Female
Head-Down Tilt*
Humans
Lung
Ovarian Neoplasms*
Ovary
Pleural Effusion*
Round Ligament of Uterus
Thorax
Uterus

Figure

• 

  Fig. 1 Pelvic computed tomography shows huge pelvic mass, suggestive ovarian mass and moderate ascites.

• 

  Fig. 2 Chest radiograph 12 days before surgery shows no evidence of the active pulmonary lesion.

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  Fig. 3 Abdomen CT 12 days before surgery shows extremely small amount of pleural effusion on right lower lung field.

• 

  Fig. 4 Portable chest radiograph after head-down tilt position shows massive pleural effusion in right lung field.

• 

  Fig. 5 Chest radiograph 1 day after chest tube insertion shows normal finding.

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