Respiratory failure after scoliosis correction surgery in patients with Prader-Willi syndrome: Two case reports

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm which typically originates from liver, lung, or bone. Due to the low incidence of disease, the most effective treatment is not easily studied and much of the information known about EHE has been learned through case reports and case series. In this case, we will present an uncommon form of primary soft tissue EHE with local recurrence, bone metastasis, and lymphangitic spread to the lungs leading to respiratory failure. Imaging of the chest was atypical for EHE with intraseptal thickening and hilar lymphadenopathy. Respiratory failure was progressive despite aggressive multimodal treatment. This case highlights an unusually aggressive recurrence and metastasis of primary soft tissue EHE with atypical pulmonary imaging findings.

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A multi-disciplinary approach to improving blood transfusion practice in paediatric scoliosis correction surgery

International Journal of Surgery ◽

10.1016/j.ijsu.2011.07.288 ◽

2011 ◽

Vol 9 (7) ◽

pp. 554

Author(s):

Shirley Lyle ◽

Richard Pinder ◽

Claire Mallinson

Keyword(s):

Blood Transfusion ◽

Transfusion Practice ◽

Scoliosis Correction ◽

Correction Surgery

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Retrospective Analysis on Intraoperative Neuromonitoring (IOM) of Potential Nerve Injury in Scoliosis Correction Surgery

Majalah Kedokteran Bandung ◽

10.15395/mkb.v53n1.2123 ◽

2021 ◽

Vol 53 (1) ◽

Author(s):

Omat Rachmat ◽

◽

Dohar AL Tobing ◽

Rr. Nur Fauziyah ◽

Jenifer Kiem Aviani ◽

...

Keyword(s):

Spinal Injury ◽

Rare Complication ◽

Intraoperative Neuromonitoring ◽

Neurological Deficits ◽

Neurological Injury ◽

Central Hospital ◽

Chi Square ◽

Post Surgery ◽

Scoliosis Correction ◽

Correction Surgery

Iatrogenic spinal injury resulting in paraplegia or paraparesis after surgical correction of scoliosis deformity is a rare complication but is very detrimental to the patient. Intraoperative Neuromonitoring (IOM) has become the gold standard to monitor surgical procedures which has potential risks to damage the spinal cord. This study aimed to retrospectively analyze the role of IOM in predicting the severity and extent of neurological injury during and after spinal correction surgery in adult idiopathic scoliosis cases related to surgical variables. This was a retrospective cohort study conducted at Dr. Cipto Mangunkusumo National Central Hospital, Fatmawati Central Hospital, and dr. Drajat Prawiranegara General Hospital during the period of 20 March 2018 to 20 August 2019. The primary outcomes were intraoperative monitoring status and post-operative neurological deficits status. Confounder data on scoliosis correction degree, intraoperative hemorrhage, and type of anesthesia used during surgery were retrieved. Chi-Square statistic was used in the analysis. Out of the ninety three patients eligible for this study, twenty two patients was detected as positive in IOM assessment. Four of the patients were found to be positive for post-operative neuromuscular defect. Thereby it can be concluded that IOM procedure can effectively prevent neurological deficits post-surgery with 81.8% specificity and 95.7% sensitivity among thosepositively detected by IOM. Some of the factors that could potentially influence false positive IOM results such as anesthetic used; dosage and administration procedures; magnitude of the scoliosis correction angle; and amount of bleeding during surgery have to be carefully analyzed.

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Subdural hemorrhage after scoliosis correction surgery - A case report -

Korean Journal of Anesthesiology ◽

10.4097/kjae.2009.56.1.116 ◽

2009 ◽

Vol 56 (1) ◽

pp. 116

Author(s):

Seung-gyu Jeon ◽

Byung Hoon Yoo ◽

Yun-Hee Lim ◽

Sangseok Lee ◽

Ki Hyuk Hong

Keyword(s):

Case Report ◽

Subdural Hemorrhage ◽

Scoliosis Correction ◽

Correction Surgery

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Acute hypercapnic respiratory failure as a rare complication of meningoencephalitis: Two case reports

Case Reports in Internal Medicine ◽

10.5430/crim.v4n2p31 ◽

2017 ◽

Vol 4 (2) ◽

pp. 31

Author(s):

Leonidas Grigorakos ◽

Katerina Tzortzopoulou ◽

Anastasia Alexopoulou ◽

Eva Sotiriou ◽

Dimitra Markopoulou ◽

...

Keyword(s):

Respiratory Failure ◽

Elderly Patients ◽

Lumbar Puncture ◽

Case Reports ◽

Rare Complication ◽

Antiviral Treatment ◽

Proper Treatment ◽

Hypercapnic Respiratory Failure ◽

Arterial Blood ◽

Acute Hypercapnic Respiratory Failure

Background: Differentiated diagnosis of meningoencephalitis in elderly patients, when an uncommon picture of respiratory infection leading to acute hypercapnic respiratory failure (AHRF) and without neurological signs is present, may raise serious difficulties.Case report: Two patients aged 72 (patient 1) and 75 (patient 2), without any medical history of respiratory problems, were hospitalized during spring with influenza symptoms. Within less than 24 hours from their admission, patients developed AHFR, which led to disturbances of arterial blood gases (ABGs). They were intubated and transferred, mechanically ventilated, to our intensive care unit (ICU). After normalization of ABGs, a weaning process followed. Weaning was unsuccessful, as unexpected neurological semiotics occurred. The imaging of neurological MRI revealed no special damage apart from microangiopathy. Further investigations through lumbar puncture with cerebrospinal fluid (CSF) testing revealed meningoencephalitis. Antiviral treatment was applied and the outcome was successful for both patients.Conclusion: Critical care medical personnel should be aware of the event of viral meningoencephalitis in elderly patients with AHRF. Especially in the middle of influenza endemic periods, the management of elderly patients may not be appropriate, thus resulting in serious delays for a proper treatment of disease. Laboratory screening of blood and urine, as well as other body fluids, can help detect and determine brain infection. Results from these tests can help exclude other diseases that mimic meningoencephalitis. In cases of patients who are hospitalized in the ICU due to AHRF and do not exhibit neurological abnormalities from the onset of illness, lumbar puncture and check of CSF should be a routine examination. Prophylactic vaccination of high-risk groups may be of crucial importance for preventing complications in patients who develop meningoencephalitis. However, once infected with this disease, the positive outcome is highly dependent on the immediate diagnosis and proper treatment of patients in the ICU.

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Scoliosis Correction Surgery in Collagen Type VI Dysfunction

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v4i3.3081 ◽

2020 ◽

Author(s):

Babak Mirzashahi ◽

Furqan Mohammed Yaseen Khan ◽

Rasul Gharakhan-Maleki

Keyword(s):

Respiratory Distress ◽

Deformity Correction ◽

Mineral Density ◽

Case Presentation ◽

Muscular Disorders ◽

Fatty Replacement ◽

Scoliosis Correction ◽

Minimize Blood Loss ◽

Correction Surgery

Background: Collagen VI (COLVI) dysfunction results in a combination of connective tissue and muscular disorders. Spinal involvement and development of scoliosis precede loss of ambulation and respiratory deterioration in these patients. Therefore, spinal deformity correction surgery is warranted to preserve ambulation and respiratory function. Case Presentation: A twelve-year-old girl presented with progressive scoliosis accompanying respiratory deterioration, sitting imbalance, and wheelchair-bound. The patient demonstrated an array of overlapping phenotypes related to COLVI dysfunction, including developmental delay, muscular dystrophy (MD), fatty replacement of skeletal muscles, and reduced bone mineral density to mention few. Patient was diagnosed with COLVI dysfunction caused by COLVI alpha 2 (COL6A2) gene mutation. She had severe phenotype expression similar to Ullrich congenital MD (UCMD). A Cobb angle of 85 degrees and thoracic kyphosis of 40 degrees were recorded. Surgical correction was performed in form of spinal fusion from T4 to S1 in addition to multiple level vertebral osteotomies. Conclusions: Respiratory distress and ambulatory problems are life-endangering events in these patients. As the disease progresses and respiratory distress increases, anesthesia becomes more difficult and the risk of surgery increases. Therefore, early intervention for correction of scoliosis is warranted to support the quality of life. Surgical time has to be kept as short as possible to minimize blood loss in these patients.

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