Expert: Dr Ian Jackson - please note UK based - 7/3/2007

Question
My sister had an esophagectomy June 25 and has not awakened since.  The day after the surgery they tried to wake her but she could not tolerate the pain so they used morphine.  She became very agitated so they put her on propofol.  Since then her heart rate stays around 140 and her blood pressure is high, her lungs have fluid and they have drained fluid from around her lungs.  She also has a high fever.  When they try to take her off the propofol, she is unresponsive.  What could be wrong?

Answer
Hi Janet
Oesophagectomy is a very large operation with a large list of potential complications. It is difficult for me to try and guess what is happening. It is however quite common for patients to develop lung problems - infections, fluid on the lungs that is difficult to control and even leaks from where the joins have been made to the bowel.
The symptoms would certainly suggest infection as part of her problem. However I cannot explain why she is not responding when they discontinue her sedation. I can only encourage you to keep asking those looking after her what is happening, what is causing the problem, what are they doing to rectify any problems and unfortunately you do need to ask how serious her condition is.
I wish you and your family strength to see this through.
Dr Ian Jackson