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Case Reports
. 2014 Dec 19:2014:bcr2014206118.
doi: 10.1136/bcr-2014-206118.

Bilateral otorrhagia: a rare complication of laparoscopic abdominopelvic surgery

Alfred Bentsi Addison  1 , Esther Inarra  2 , Simon Watts  3
Affiliations
Case Reports

Bilateral otorrhagia: a rare complication of laparoscopic abdominopelvic surgery

Alfred Bentsi Addison et al. BMJ Case Rep. .

Abstract

An 80-year-old woman without any previous otological symptoms underwent laparoscopic abdominoperineal resection for T3N0M0 low rectal carcinoma 4-5 cm from the anal verge. The total operative time was 6 h, of which she spent long hours in the Trendelenburg (35°) position due to difficult pelvic dissection. Midway through the procedure, she developed spontaneous non-traumatic bilateral otorrhagia. This case highlights the potential risk of increased intracranial pressure during prolonged periods of being in a steep Trendelenburg position caused either by the position itself or in combination with carbon dioxide pneumoperitoneum. We also consider the effect of a sudden change from this position to supine as a potential risk.

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