Severe Hypotension Associated with Insertion of an Alexis® Wound Protector or Retractor during Lower Abdominal Surgery in a Child: A Case Report - Abstract
We present a case of severe hypotension associated with insertion of an Alexis® wound protector/retractor during lower abdominal surgery in a child. A 3-year old female patient underwent ureteroneocystostomy for vesicoureteral reflux under general anesthesia. After skin incision in the lower abdomen, the retractor was
placed in position through the incision in the lower abdominal wall, with the inner ring inside the abdomen. Following insertion of the retractor, the patient’s blood pressure dropped from 95/40 mmHg to 45/20 mmHg. Physical examination and transthoracic echocardiography did not indicate any signs of anaphylactic reaction, cardiac dysfunction, or pulmonary embolism, and after removal of the wound retractor, the patient’s blood pressure quickly recovered to the baseline level. Because these wound retractors may cause severe hypotension, it is important to pay particular attention to blood pressure when they are used in small children undergoing abdominal surgery.