Case Report

Anesthetic Management of Exploratory Laparotomy for Strangulated Umbilical Hernia in a Neonate with Mixed-Type TAPVC: A Case Report

Abstract

Mixed-type total anomalous pulmonary venous connection (TAPVC) in a neonate requiring emergency surgical intervention for a strangulated umbilical hernia presents unique anesthetic challenges. We report successful perioperative management of a 24-day-old male infant (3.2 kg) with mixed TAPVC posted for exploratory laparotomy. Key management strategies included careful modulation of pulmonary and systemic vascular resistance, strategic use of inotropic support, and meticulous monitoring of oxygen delivery in the context of right-to-left shunting. The patient remained hemodynamically stable throughout surgery and was successfully managed postoperatively with graduated ventilatory support. This case highlights the critical importance of coordinated anesthetic and surgical planning in neonates with complex congenital heart disease undergoing non-cardiac emergency procedures.

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Keywords
TAPVC Neonatal anesthesia Umbilical hernia Congenital heart disease Inotropic support
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How to Cite
1.
Khatavkar S, Wadikar P, Yerramshetty M. Anesthetic Management of Exploratory Laparotomy for Strangulated Umbilical Hernia in a Neonate with Mixed-Type TAPVC: A Case Report. Arch Anesth & Crit Care. 2026;.