scholarly journals Successful airway management of twin coincidental supraglottic and thyroid masses with difficult fiber optic intubation: a case report

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Chashamjot Bawa ◽  
Babita Ramdev ◽  
Rashi Sarna ◽  
Praveena Venkatreddy Reddum

Abstract Background Aberrant airway anatomy in cases of laryngeal carcinomas makes airway management a herculean task for the anesthesiologist. What can further compound the situation is an external compression by thyroid mass. Case presentation We present a case report of successful airway management by awake nasal fiberoptic intubation in a 65-year-old male who was found to have compressive symptoms due to thyroid swelling in addition to supraglottic obstructive mass. Although a detailed airway examination and indirect laryngoscope did assist in planning the procedure, but what lay inside could only be dealt with by having an in-depth orientation of airway anatomy, practical know-how to fiberoptic scope, and swift reflexes to prevent an adverse event. Conclusion From our experience, fiberoptic intubation can only be optimally utilized if emphasis is laid on planning and preparation for the procedure which are key elements in making any difficult airway management successful.

2020 ◽  
Vol 4 (10) ◽  
pp. 898-900
Author(s):  
Ahmet GÜLTEKİN ◽  
İlker YILDIRIM ◽  
Ayhan SAHİN ◽  
Cavidan ARAR

2019 ◽  
Vol 47 (7) ◽  
pp. 3416-3420
Author(s):  
Sung Min Lee ◽  
Hyunyoung Lim

A 68-year-old patient with a huge dangling vocal papilloma was admitted for surgical resection. Preoperative data regarding the patient’s mass-related symptoms, endoscopic view, and radiological evaluation indicated that airway management would be difficult. Fiberoptic intubation has been considered an ideal primary approach to managing problematic airways, but blind advancement of the endotracheal tube without a clear, consistent view of the mass presents a significant threat to patient safety. This report describes how safe intubation was accomplished while the patient was awake using laryngeal nerve blocks and a McGrath® videolaryngoscope.


Author(s):  
Arash Heroabadi ◽  
Noushin Khazaei ◽  
Ashkan Asadollah Baik ◽  
Ali Movafegh ◽  
Omid Azimaragh

Video laryngoscopy has opened its way into airway management and continues to play a larger role in managing patients with difficult airway. Anesthesiologists use video laryngoscopy more often every day and therefore accept the risks of more challenging and difficult airway situations with more confidence. In the mentioned case below, a 45-year-old female with a large thyroid mass is presented to an academic based hospital, for elective thyroidectomy. The patient was intubated using a video laryngoscopy technique and the airway was secured. Video laryngoscopy helps secure difficult airways and could be chosen as first line option in such situations.


2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.


Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.


2020 ◽  
Vol 30 (3) ◽  
pp. 56-59
Author(s):  
Jūratė Gudaitytė ◽  
Justina Jermolajevaitė ◽  
Martynas Judickas

Background and objectives: Acromegaly is endocri­nal disorder which results in changes involving ge­neral appearance as well as upper airway abnorma­lities, cardiovascular and metabolic disorders which can aggravate the anesthesia and can lead to compli­cations. We aim to discuss the challenges for anesthe­siologist that occurs facing patient with acromegaly and are necessary to investigate before performing any kind of intervention. Case Presentation: 79 years old male patient presen­ted the hospital with recently diagnosed acromegaly for rectal prolapse surgery. From anamnesis he had NYHAIII with cardiomyopathy, atrial fibrillation and arterial hypertension, also multiple old compressive fractures Th10 – L5. He was graded with Mallam­pati score IV and ASA class IV. The complemen­tary examinations were made to assess the possible complications. In induction of general anesthesia the intubation was performed using fibro- bronchoscope and anesthesia went without complications except hypotension which was managed. After surgery the patient was leaded to the postoperative room for furt­her monitoring. Discussion and Conclusion: Acromegalic patients have an increased risk of difficulty during anesthe­sia compared to general population due to difficult intubation, cardiovascular complications , OSA , alte­ration in intraoperative glucose intolerance and fluid regulation. Therefore profound investigation and as­sessment are necessary to predict and prepare for possible difficulties in the surgery room.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Anne-Jet S. Jansen ◽  
Paul M. van Schaik ◽  
Jasper M. Martens ◽  
Michel M. P. J. Reijnen

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Zhang ◽  
Cheng Chen ◽  
Min Lin ◽  
Kan Deng ◽  
Huijuan Zhu ◽  
...  

Abstract Background Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual. Case presentation A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020. Conclusions Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Min Li ◽  
Gang Zhu ◽  
Hao Guo ◽  
Shun Nan Ge ◽  
Guo Dong Gao ◽  
...  

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.


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