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Interesting Case of Ruptured Ectopic Pregnancy Presenting with WPW syndrome .

Interesting Case of Ruptured Ectopic Pregnancy Presenting with WPW syndrome. Dr Dinesh Kumar Post graduate Dr P.S.Nag Head of the Department Dr Poorna Chandran Senior Resident Meenakshi Medical College & Research Institute. History.

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Interesting Case of Ruptured Ectopic Pregnancy Presenting with WPW syndrome .

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  1. Interesting Case of Ruptured Ectopic Pregnancy Presenting with WPW syndrome. • Dr Dinesh Kumar Post graduate • Dr P.S.Nag Head of the Department • Dr PoornaChandran Senior Resident • Meenakshi Medical College & Research Institute

  2. History • A 24 year old women who was a known case of WPW syndrome presented to the casualty with • Severe Lower Abdominal pain, • Vomiting, • Giddiness.

  3. EXAMINATION • She was pale, Severely dehydrated, Pulse was 170, BP was 80/60, Abdomen was tender and rigidity +, CVS ,RS were normal.

  4. Opinion • Emergency Ultra sound was done & Obsterician diagnosed Ruptured ectopic Pregnancy. • She was posted for Emergency Lapratomy.

  5. ANAESTHETIC MANAGEMENT • Peripheral IV Line was secured with 14 G and 16 G needle, • Patient was resuscitated with blood transfusion. • Basic Investigations were done, • HB was 5.3, • ECG showed tachy cardia. No arrythmias.

  6. Intra op • Patient was connected to Basic monitoring, • Premedication Given with Glycopyrolate & Fentanyl • Pre Oxygenated with 100 % oxygen for 5 mins • Induction done with Propofol & Succinyl Choline • Intubated with 7.5 ET Tube bil air entry checked • Maintanence with 50 : 50 N2o & O2, Isoflurane 0.6% Atracurium • Nil signiicant events intra operatively • All measures were kept ready to manage tachy or brady arrythmia

  7. Post Op • Patient was shifted to Surgical ICU post operatively and extubated after full recovery and hemodynamic ally stable. • Post operatively she developed Hypoxia she was re-intubated and managed with IPPV for one day and extubated next day. • she recovered well and she was discharged on 10th day.

  8. Complete Diagnosis • Post operatively we got the old records which showed WPW syndrome post ablation status- • EPS showed sucessful abalation • Though she was sucessful case of post RF abalation we treated here as a case of WPW syndrome and took all precaution to prevent complication of WPW syndrome …..

  9. WPW Syndrome

  10. What exactly is WPW syndrome? Syndrome with • Accessory pathway between atria & ventricle • This results in preexcitationof ventricle • Associated with tachycardia

  11. QRS starts earlyCurve is slurred –going through muscleThis

  12. Discussion • WPW syndrome --- Post RF abalation status presenting with severe shock for Lapratomy how to manage ?

  13. Thank You

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