Abstract

NUNES, Andreia Mercier et al. Extravasamento de fluido para a cavidade intra-abdominal e torácica após artroscopia da anca. Rev. Port. Ortop. Traum. [online]. 2018, vol.26, n.4, pp.355-361. ISSN 1646-2122.

Aim: The number of hip arthroscopies is increasing with a low reported major complication rate. A rare but major complication is fluid extravasion to the intraperitoneal and retroperitoneal spaces and even to the thoracic cavity. We present two cases of intra-abdominal and intra-thoracic fluid extravasion after hip arthroscopy, aiming to emphasize potential risk factors, prevention and treatment of this complication. Case: Both patients in this case report underwent a hip arthroscopy for femoroacetabular impingement, and both have had previous abdominal surgery. After surgery they presented abdominal distension, respiratory distress and hypothermia due to fluid extravasion to the abdominal and thoracic cavity. Endovenous diuretic treatment was started, and one of the patients needed a therapeutic thoracentesis. Both had a good response to the treatment and at 6 months follow-up presented a good functional outcome and no evidence of the fluid extravasion. Comments: Symptomatic abdominal fluid extravasation during hip arthroscopy is rare and thoracic fluid extravasion is even more rare. Iliopsoas tendon sheath is the most likely route for fluid extravasion, as well as an early and extended hip capsulotomy. The authors believe that previous abdominal surgery can contribute for this complication. A high suspicion index and a very watchful team (surgeon and anesthetist) can detect this complication and prevent a potentially catastrophic outcome

Keywords : Hip arthroscopy; Fluid extravasation.

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