scholarly journals Prenatal diagnosis of congenital high airway obstruction syndrome: our experience from a tertiary care center

2020 ◽  
Vol 9 (9) ◽  
pp. 3858
Author(s):  
Deepti Saxena ◽  
Shubha R. Phadke
Keyword(s):  
Airway Obstruction ◽  
Antenatal Diagnosis ◽  
Care Center ◽  
Tertiary Care ◽  
Upper Airway ◽  
Fetal Autopsy ◽  
Antenatal Ultrasound ◽  
Risk Of Recurrence ◽  
Threatening Condition ◽  
Fetal Karyotype

Congenital high airway obstruction syndrome (CHAOS) is an extremely rare and life-threatening condition. It occurs due to obstruction in fetal respiratory tract and is characterized by typical ultrasonographic findings. Risk of recurrence is low, so antenatal diagnosis can help in counselling regarding risk of recurrence. A retrospective record review of all cases referred to our institution for antenatal ultrasound over a period of 5 years from January, 2014 to December, 2018 was done. Cases diagnosed as CHAOS were reviewed in detail regarding the radiological findings, information regarding delivery, fetal karyotype and postnatal/ fetal examination. Between the period of 2014 to 2018 three fetuses with CHAOS were identified. All of them had characteristic radiological features. Two of them were associated with hydrops and one fetus had oligohydramnios. All the pregnancies were terminated after antenatal diagnosis. Amniocentesis was done in 2 out of 3 cases and fetal karyotype was found to be normal. Fetal autopsy was done in one case and site of upper airway obstruction was identified. Confirmation of diagnosis by antenatal ultrasound and if possible, by post-mortem examination is essential for providing estimation of risk of recurrence to the family and genetic counselling.

Arytenoid Prolapse following Laryngotracheoplasty

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P62-P62
Author(s):  
Catherine K. Hart ◽  
Gresham T. Richter ◽  
Robin T Cotton ◽  
Michael J Rutter
Keyword(s):  
Airway Obstruction ◽  
Clinical Features ◽  
Sleep Disordered Breathing ◽  
Chart Review ◽  
Tertiary Care ◽  
Upper Airway ◽  
History Of ◽  
Tertiary Care Institution ◽  
Second Procedure ◽  
Retrospective Database

Objective Dynamic arytenoid prolapse (AP) is a potential and often late source of upper airway obstruction in children following laryngotrachoplasty (LTP). Reasons for this occurrence remain unclear. We examined the incidence and clinical features of AP in patients following LTP to explore the etiology and optimal surgical approach to this problem. Methods Retrospective database and chart review of children diagnosed with AP after LTP at a pediatric tertiary care institution from 1981–2007. Results 120 patients with no history of AP were diagnosed with AP following LTP (incidence 7.3% = 120/1634). 63 patients had unilateral prolapse, while 57 had bilateral AP. Average time from LTP to presentation was 44 months. Common symptoms were dyspnea on exertion, tracheostomy-dependence, and sleep-disordered breathing. Posterior cricoid interventions and revision LTP were most frequently associated with postoperative AP. 64% (n=77) of patients required surgical intervention. Endoscopic arytenoid reduction (AR) was performed in 54 patients, while 13 underwent AR during revision LTP. 2 patients underwent AR with cordotomy. Tracheostomy was performed with AR in another 2 patients. 28 patients required a second procedure for persistent prolapse. 36%(n=42) of patients did not require surgery. Airway complaints were relieved, or tracheostomy decannulation was achieved, in all patients after AR in which AP was the source of obstruction (avg. f/u=34.4mos). Conclusions Dynamic AP is a notable cause of airway obstruction following LTP. Subtle airway complaints and decannulation failures are common clinical features. Both endoscopic and open AR procedures are successful in relieving AP. Potential etiology for AP after LTP is discussed.

scholarly journals Emergent thyroidectomy with sternotomy due to acute respiratory failure with severe thyroid storm

2018 ◽  
Vol 100 (8) ◽  
pp. e223-e225
Author(s):  
A Matsushita ◽  
S Hosokawa ◽  
D Mochizuki ◽  
J Okamura ◽  
K Funai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Airway Obstruction ◽  
Total Thyroidectomy ◽  
Upper Airway ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Nasal Intubation ◽  
Threatening Condition ◽  
Life Threatening

Huge cervical and mediastinal masses may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Thyroid storm is also a life-threatening endocrine emergency originating almost exclusively from uncontrolled Graves’ disease. We report a case of a 42-year-old man with acute upper airway obstruction and tachycardia from progressive swelling of a giant thyroid, in conjunction with thyroid storm resulting from uncontrolled Graves’ disease. Fibreoptic-assisted nasal intubation was performed while the patient was awake, immediately followed by emergency total thyroidectomy via a cervical and sternal approach. The patient had an uneventful postoperative course and recovered well. Respiratory failure due to swelling of a giant thyroid is a life-threatening condition and should be treated immediately with endotracheal intubation while the patient is awake following emergent total thyroidectomy, even with a sternotomy.

scholarly journals Study of cases of post-partum hemorrhage after spontaneous vaginal delivery in labour room of obstetrics and gynecology department of tertiary care center, Ranchi, Jharkhand, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1540
Author(s):  
Bratati Moitra ◽  
Bulllu Priya Oraon
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Maternal Death ◽  
Post Partum ◽  
Care Center ◽  
Tertiary Care ◽  
Spontaneous Vaginal Delivery ◽  
Lower Middle Class ◽  
Threatening Condition ◽  
Labour Room

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.

Croup and Related Disorders

1993 ◽  
Vol 14 (1) ◽  
pp. 19-29
Author(s):  
Joseph R. Custer
Keyword(s):  
Airway Obstruction ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Upper Airway ◽  
Organ Damage ◽  
Upper Airway Obstruction ◽  
Retropharyngeal Abscess ◽  
Radiology Department ◽  
Team Approach ◽  
Airway Infections

The airway of children is vital, but easily obstructed because it is narrow. Although there are many potential causes of upper airway obstruction (Table 1), a few diagnoses predominate. For example, in one study of 322 children presenting with stridor, 89% of cases were caused by croup, 8% by epiglottitis, and 2% by nonbacterial tracheitis.1 This review will cover these common airway infections as well as obstruction caused by inhalation of foreign bodies, spasmodic croup, and retropharyngeal abscess. Each of these diseases can progress to critical airway obstruction and hypoxia, causing organ damage or death. Individuals caring for children must be prepared to diagnose and treat airway emergencies expeditiously. Appropriate management of acute upper airway obstruction tests the organization of emergency care systems. Successful management of airway emergencies requires a team approach, including the skills of the primary physician and the staff of the emergency department, radiology department, and operating room (eg, anesthesiologist, otolaryngologist). Management of these cases can be anticipated, and prospective protocols can and should be established. Regional intensive care units, transport teams, emergency room personnel, primary care physicians, anesthesiologists, and otolaryngologists can agree on a prospective management scheme such as that outlined in Table 2. The issue of airway protection prior to or during transport to a tertiary care institution is controversial.

CASE SERIES OF PREGNANCY-ASSOCIATED MYOCARDIAL INFARCTION: AN EPIDEMIC IN WAITING

2021 ◽  
pp. 28-30
Author(s):  
Shree Bharathi ◽  
Sasirekha Rengaraj
Keyword(s):  
Myocardial Infarction ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Fetal Outcome ◽  
Therapeutic Implications ◽  
Threatening Condition ◽  
Life Threatening ◽  
Common Etiology ◽  
Artery Disease

Acute myocardial infarction during pregnancy or postpartum period is a rare but life-threatening condition associated with poor maternal and fetal outcome. Although atherosclerotic coronary artery disease is the most common etiology in general population, the causation is more diverse in pregnancy and this may have therapeutic implications. Early diagnosis and timely management with collaboration among Maternal-fetal medicine specialist, interventional cardiologist, cardiac anaesthetist, intensivist and neonatologist is essential to prevent maternal cardiac deaths. We present a case series of two patients with postpartum and antepartum acute MI, respectively and their diagnosis, management and outcomes in a tertiary care center.

Tracheotomy in the Preschool Population: Indications and Outcomes

2007 ◽  
Vol 137 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Lesley C. French ◽  
Christopher T. Wootten ◽  
Robert G. Thomas ◽  
Wallace W. Neblett ◽  
Jay A. Werkhaven ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Direct Result ◽  
First Year ◽  
Care Hospital ◽  
Age Group ◽  
First Year Of Life

OBJECTIVE: Although more tracheotomy procedures are performed within the first year of life than in any other age group, preschool-aged children requiring tracheotomy remain understudied. We characterize the indications and outcomes for patients between the ages of 3 and 6 years undergoing tracheotomy. METHODS: Out of 480 pediatric tracheotomy procedures performed at a tertiary-care hospital between 1988 and 2004, 15 patients underwent primary tracheotomy between 3 and 6 years of age. RESULTS: Most (60%) procedures were performed for pulmonary toilet. Upper-airway obstruction represented the second most common indication (40%), and trauma necessitated tracheotomy procedures more often than had been predicted (40%). The decannulation rate was 40%; 2 patients died. CONCLUSION: Trauma contributed to both upper-airway obstruction as well as requirements for pulmonary toilet. These procedures performed secondary to trauma will likely continue to increase. SIGNIFICANCE: Tracheotomy procedures in the preschool population remain uncommon; however, nearly half of those studied were performed as a direct result of otherwise preventable trauma.

scholarly journals Clinical study of ectopic pregnancy at tertiary care center in Haryana, India

2019 ◽  
Vol 8 (7) ◽  
pp. 2816
Author(s):  
Sushila Chaudhary ◽  
Meenakshi B. Chauhan ◽  
Anjali Gupta ◽  
Monika Dalal
Keyword(s):  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
First Trimester ◽  
Sexual Practices ◽  
Care Hospital ◽  
Threatening Condition ◽  
Incidence Risk ◽  
Β Hcg

Background: Ectopic pregnancy is a life threatening condition in the first trimester of pregnancy. Diagnosis can be done by clinical examination, serum β-HCG and ultrasonography. This retrospective study was done to know the incidence, risk factors, and management of ectopic pregnancy.Methods: It was a retrospective study conducted on 75 patients of ectopic pregnancy admitted at tertiary care hospital in Haryana from February-2017 to January-2019. Data collected from record room and analysis done.Results: Total deliveries were conducted were 5064. The incidence of ectopic pregnancy was 1.48%, majority of the women were in the age group of 21-30 (68%), multi-parous (77.32%). The most common risk factor was abortion 33.33%, f/b tubal ligation was 13.13%, medical management of ectopic pregnancy done in 30.66%, 8% were managed by laproscopically and 58.66% by laparotomy.Conclusions: Safe sexual practices can reduce pelvic infections and ectopic pregnancy incidences. Early diagnosis before tubal rupture can reduce morbidity and mortality in ectopic pregnancy.

Acute Edema of the Tongue: A Life-Threatening Condition

2003 ◽  
Vol 112 (7) ◽  
pp. 651-653 ◽  
Author(s):  
Hussein Gadban ◽  
Yoav Talmon ◽  
Peter Gilbey ◽  
Alvin Samet
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Emergency Intervention ◽  
First Case ◽  
Threatening Condition ◽  
Life Threatening

Acute macroglossia is rare, but may cause upper airway obstruction requiring emergency intervention. The cause of the problem is often obscure. Edema of the tongue may be due to angioedema or to allergy. We present several cases of acute edema of the tongue, in 3 cases causing life-threatening airway obstruction. Among these, we present the first case of acute enlargement of the tongue due to the ingestion of artichoke.

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