Volume 27
Number 3
Jul 2019
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Case Reports
T.H.W. Leuverink, C.M.H. Nolte, O.M. van Delden, R. Tepaske, O.R. Busch,

This report describes the case of a 36-year-old woman who presented to our intensive care unit in profound refractory shock after a complicated laparoscopic cholecystectomy. Transoesophageal echocardiography showed an extrapericardial mass blocking venous return and computed tomography showed an intra-abdominal haematoma with displacement of the liver. The patient was diagnosed with extrapericardial tamponade caused by compression of the right atrium by the liver due to a large intra-abdominal haematoma. Decompression via explorative laparotomy was performed, resulting in a quick and full recovery of the patient. We conclude that extrapericardial tamponade should be considered in patients presenting with refractory shock after abdominal surgery.

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