Post Appendectomy Blindness, Extremely rare complication after abdominal surgery

doi:10.28933/ijcr-2020-11-2805

Abstract

Perioperative visual loss (POVL) is a drastic complication that can result after ocular and more commonly non-ocular surgery, mostly reported after spine and cardiac bypass procedures. Despite the rarity of such complication, it has been reported following the abdominal surgeries. Overall, the most common cause of POVL is ischemic optic neuropathy but any pathology to the optical system from the cornea to the occipital lobe can lead to this rare phenomenon. Here, we are reporting the second case in the literature of post-operative visual loss after laparoscopic appendectomy. A young female, with no underlying disease, underwent laparoscopic appendectomy after septic shock secondary to acute appendicitis. Postoperatively, patient complained of complete blindness after extubation. Neurologic examination revealed bilateral near complete blindness, and hemodynamic ischemic stroke in the occipital cortex.

Highlights

Appendectomy is a one of the most common surgical procedure performed in emergency general surgery
Despite 2 liters of IV fluids, the patient was persistently hypotensive, signifying septic shock, and her hemoglobin was 9 g/dL, so a unit of Packed Red Blood cells was transfused during resuscitation. Her labs were significant for white cell count of 2.8, and lactate of 4.9. She was continuously resuscitated with aggressive fluid and intravenous Tazocin, and diagnosis of appendicitis was made on computed tomography (CT), of the abdomen and the patient was shifted to operation room for Laparoscopic appendectomy
Perioperative visual loss (POVL) after non-ocular surgery describes either unilateral or bilateral visual impairment that occurs after general surgery apart from ophthalmic operations

Summary

Introduction

Appendectomy is a one of the most common surgical procedure performed in emergency general surgery. Neurologic examination Post Appendectomy Blindness, Exrevealed bilateral near complete blindness, and hemodynamic tremely rare complication after abischemic stroke in the occipital cortex. Post appendectomy visual loss is extremely rare complication following abdominal surgery and was only reported once before [1].

Results

Conclusion