Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
Korean J Anesthesiol. 2011 Mar;60(3):221-5. doi: 10.4097/kjae.2011.60.3.221. Epub 2011 Mar 30.
A 53-year-old woman who had undergone total gastrectomy and received adjuvant chemotherapy two months ago underwent adhesiolysis of the small bowel. She presented with sudden desaturation and dyspnea of unknown etiology at postanesthetic care unit. Following ET intubation, the endotracheal tube suction revealed massive hemoptysis. Bilateral lung infiltrated on her chest radiograph and bronchofibroscopic examination disclosed a diffuse hemorrhage on both lung fields without bleeding focus. These findings were consistent with diffuse alveolar hemorrhage (DAH) syndrome. As per our knowledge and search, this is the first reported case of DAH that occurred during the recovery period immediately after general anesthesia. DAH is known to have a high mortality rate and an early detection followed by adequate treatment is essential.
一位 53 岁女性，两个月前因全胃切除术接受辅助化疗，行小肠粘连松解术。在麻醉后护理单元时出现突发性血氧饱和度下降和不明原因的呼吸困难。经气管插管后，气管内导管吸引发现大量咯血。胸部 X 线和支气管纤维镜检查显示双侧肺浸润，双肺弥漫性出血而无出血灶。这些发现与弥漫性肺泡出血（DAH）综合征一致。据我们所知和检索，这是首例在全麻恢复期立即发生 DAH 的报道病例。DAH 死亡率高，早期发现和充分治疗至关重要。
