Systemic capillary leak syndrome (SCLS) is very rare and lethal disease and only 150 cases have been reported after the first publication of its report in 1960 by Clarkson. SCLS is characterized by hemoconcentation and
hypoalbuminemia caused by reversible plasma extravasation. Its mechanism is unknown, but transient dysfunction of the endothelium is the most suspected cause and trigger of this event may cause immunologic disarrangement. After recovery of endothelial function, fluid injected during the
shock period is redistributed and can cause severe
pulmonary edema. SCLS should be considered in patients with acute and severe
hypotension with hemoconcentration and
hypoalbuminemia without obvious cardiac dysfunction. Especially we should take into account the possibility of SCLS if fluid replacement does not work or the
shock state is aggravated despite aggressive fluid
resuscitation and vasopressor administration. SCLS itself is a very
rare disease; furthermore, SCLS that develops during well-controlled surgery is even more rare. So we report this case with review of the literature.