Inferior Vena Cava Syndrome Caused by Port Site Hemorrhage as a Complication of Laparoscopic Adrenalectomy

Abstract

Inferior vena cava (IVC) syndrome results from obstruction of the IVC. Occlusion of the IVC caused by external pressure is a well-recognized complication of malignancy; meanwhile, benign causes of IVC obstruction are not frequently encountered without deep vein thrombosis. There have been a few reports of benign external compression of the IVC. We here show a rare and unique case of benign IVC syndrome in a 47-year-old woman, which was caused by hemorrhage as a complication of laparoscopic adrenalectomy on postoperative day 1. She had undergone laparoscopic adrenalectomy, performed successfully for primary aldosteronism, but she lost consciousness for about 10 seconds on postoperative day 1. After emergency medical care, her sinus rhythm and stable hemodynamic status were restored. At that time, computed tomography showed retroperitoneal hematoma caused by port site bleeding with the IVC compressed excessively, and we considered that drastic IVC syndrome may have occurred. Hemostatics and complete rest improved her general condition gradually, and she left the hospital on postoperative day 20. Laparoscopic adrenalectomy is technically feasible and has several advantages over open adrenalectomy, such as less intraoperative blood loss and a shorter hospital stay. However, surgeons must be careful of potential critical complications.