Images in Clinical Medicine
Bright Green Serum
N Engl J Med 2007; 356:e10March 15, 2007
- Article
A 49-year-old woman was admitted to the hospital for evaluation of abdominal pain. Her hospital course was complicated by contrast-medium–induced renal failure requiring dialysis. She subsequently underwent resection of an adnexal mass, 16 cm in diameter. Four hours after surgery, the patient was found to have bright green serum that persisted for 4 days. Intraoperative angiography with a fluorescent dye (total dose, approximately 800 mg) and a Wood's lamp had been used to evaluate mesenteric-vessel viability. Although this dye normally clears rapidly from the blood, it persisted in this patient owing to the acute renal failure. The mass was diagnosed as colon cancer, which was found to be metastatic. The patient died from complications of the cancer 7 months later.
Helen Bailey, M.D.
Alan H.B. Wu, Ph.D.
University of California, San Francisco, San Francisco, CA 94110
wualan@labmed2.ucsf. edu
