scholarly journals Peri-operative anaesthesia challenges in large anterior mediastinal mass - A case report

2021 ◽  
Vol 8 (4) ◽  
pp. 604-607
Author(s):  
Rachna Wadhwa ◽  
Varun Sharma ◽  
Pallavi Ahluwalia ◽  
Vishnu Datt
Keyword(s):  
Anterior Mediastinum ◽  
Anterior Mediastinal Mass ◽  
Unknown Etiology ◽  
Ct Guided ◽  
Airway Compression ◽  
X Ray ◽  
Airway Collapse ◽  
Ct Guided Biopsy ◽  
Residual Capacity ◽  
Chest X Ray

Thymic mass is a rare tumor in the anterior mediastinum. They are usually of unknown etiology. About 50% of patients are diagnosed incidentally on chest radiographs. A 45 years, BMI-28, male patient presented to cardiac outpatient department with breathlessness and persistent cough for past three months. He also complained of generalized fatigue and nonspecific chest pain. On chest x-ray (PA view), there were diffuse opacities in middle and lower zone and no tracheal compression or deviation. Lateral neck X-ray also ruled out any airway compression. Computed tomography thorax revealed a huge mass occupying the prevascular compartment of mediastinum and insinuating the visceral compartment bilaterally with extension upto bilateral cardiophrenic and anterior costophrenic angles. CT-guided biopsy was consistent with thymolipoma which was surgically resected.Thymolipomas usually present with nonspecific symptoms. They pose a huge anaesthetic challenge during the peri-operative period in terms of difficult intubation, co-existing airway compression requiring reinforced tubes and fiberoptic guidance, the possibility of sudden airway collapse post-induction, risk of hypoxemia secondary to reduced functional residual capacity (FRC) and haemodynamic disturbances during and after removal of huge mass.

scholarly journals A case report on incidental finding of thymoma as anterior mediastinal mass

2019 ◽  
Vol 8 (6) ◽  
pp. 1441
Author(s):  
Nithin K. T. ◽  
Vikas Kumar ◽  
P. Prasanth
Keyword(s):  
Mediastinal Mass ◽  
Incidental Finding ◽  
Primary Treatment ◽  
Anterior Mediastinum ◽  
Anterior Mediastinal Mass ◽  
Unknown Etiology ◽  
Mediastinal Tumors ◽  
Mediastinal Widening ◽  
Chest X Ray ◽  
Heterogeneous Solid

Thymomas are rare tumors in the anterior mediastinum, representing 50% of anterior mediastinal masses and about 20-30% of all mediastinal tumors. They are of unknown etiology; about 50% of patients with thymomas are diagnosed incidentally with chest radiography. Thymoma is classified into different stages, which determine the prognosis and type of management, the standard primary treatment for these tumors is Thymectomy. We present a case of 55-year female presented with shortness of breath, cough with expectoration and fever for past ten days. Chest x-ray revealed mediastinal widening. CECT chest showed a well-circumscribed heterogeneous solid enhancing mass lesion. FNAC was planned that showed features in favour of thymoma. Biopsy was done that confirmed lymphocyte rich type B thymoma.

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

scholarly journals Vitamin K Deficiency Presenting in an Infant with an Anterior Mediastinal Mass: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Mauricio A. Palau ◽  
Amanda Winters ◽  
Xiayuan Liang ◽  
Rachelle Nuss ◽  
Susan Niermeyer ◽  
...  
Keyword(s):  
Vitamin K ◽  
Mediastinal Mass ◽  
Anterior Mediastinum ◽  
Medical Attention ◽  
Anterior Mediastinal Mass ◽  
Vitamin K Deficiency ◽  
K Deficiency ◽  
Chest X Ray ◽  
Work Up

We report a case of a 1-month-old infant with spontaneous thymic hemorrhage secondary to severe vitamin K deficiency. He was brought to medical attention due to scrotal bruising and during evaluation was noted to be tachypneic and hypoxemic. Chest X-ray revealed an enlarged cardiothymic silhouette, and a follow-up echocardiogram revealed a mass in the anterior mediastinum. Routine laboratory work-up revealed severe coagulopathy. Further questioning revealed the patient had not received prophylactic vitamin K at birth. The coagulopathy resolved with administration of vitamin K, and a biopsy confirmed the anterior mediastinal mass was due to spontaneous thymic hemorrhage.

Is a Routine Chest X-ray Necessary in Every Patient After Percutaneous CT-Guided Lung Biopsy? A Retrospective Review of 278 Cases

2017 ◽  
Vol 40 (9) ◽  
pp. 1415-1420 ◽  
Author(s):  
Shayandokht Taleb ◽  
Hamed Jalaeian ◽  
Nickolas Frank ◽  
Jafar Golzarian ◽  
Donna D’Souza
Keyword(s):  
Retrospective Review ◽  
Lung Biopsy ◽  
Ct Guided ◽  
X Ray ◽  
Chest X Ray ◽  
Routine Chest

scholarly journals Large posterior mediastinal goiter post total cervical thyroidectomy: a case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2722
Author(s):  
Maria Fesatidou ◽  
Vasiliki Fesatidou ◽  
Georgios Tsoulfas ◽  
Ioannis T. Fessatidis
Keyword(s):  
Computed Tomography ◽  
Mediastinal Mass ◽  
Thyroid Tissue ◽  
Ct Guided ◽  
X Ray ◽  
Surgical Safety ◽  
Chest X Ray ◽  
Posterior Mediastinal ◽  
Lateral Thoracotomy ◽  
Mediastinal Goiter

Thoracotomy approach is indicated for a complete and safe posterior mediastinal goitre removal. A 68 years old male was hospitalized due to a right mediastinal mass found in a chest X-ray and confirmed by computed tomography. The patient had undergone total cervical thyroidectomy thirty years ago. A computed tomography (CT) guided percutaneous needle biopsy of the mass revealed thyroid tissue. Subsequently, the mass was completely resected through a right posterolateral thoracotomy. The histopathology confirmed a large mediastinal goitre with no signs of malignancy. The patient had an uncomplicated recovery. We present a relatively rare case of a successful resection of a posterior mediastinal goitre, occurring thirty years post-total cervical thyroidectomy. We advocate lateral thoracotomy to achieve a broad operative field and enhance surgical safety.

scholarly journals Massive Myocardial Infarction in a Full-Term Newborn: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Vlasta Fesslova ◽  
Gina Lucci ◽  
Jelena Brankovic ◽  
Stefania Cordaro ◽  
Emilio Caselli ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Hypertrophy ◽  
Full Term ◽  
Unknown Etiology ◽  
Cardiac Massage ◽  
External Cardiac Massage ◽  
X Ray ◽  
Rh Isoimmunization ◽  
Ventilatory Assistance ◽  
Chest X Ray

A full-term female newborn with neonatal asphyxia and severe anemia (Hb 2.5 g/dL) with normal heart developed a massive myocardial infarction. No examinations were performed during pregnancy for parental nomadism. The baby had immediate external cardiac massage, ventilatory assistance, and blood transfusion. Cardiomegaly was evident at chest X-ray and marked signs of ischemia-lesion at ECG. Echocardiography showed dilated, hypertrophic, and hypocontractile left ventricle (LV), mitral and tricuspid regurgitation, and moderate pericardial effusion. Rh isoimmunization and infective agents were excluded at laboratory tests. Despite the treatment with inotropes, hydrocortisone, and furosemide, the baby worsened and died at 45 hours of life. Postmortem examination showed diffuse subendocardial infarction of LV and diffuse parenchymal hemorrhages and myocardial hypertrophy, increase of eosinophilia, and polymorphonucleated cells at histology. Our patient suffered apparently from longstanding fetal anemia of unknown etiology that led to perinatal distress, severe hypoxia, and massive myocardial infarction, unresponsive to the therapy.

scholarly journals Primary small cell neuroendocrine carcinoma of the anterior mediastinum presenting with trepopnea

2018 ◽  
Vol 11 (1) ◽  
pp. e225014
Author(s):  
Mohamed Iliyas ◽  
Das Dona ◽  
Uma Devi ◽  
Naseem Noorunnisa
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Outpatient Care ◽  
Delayed Diagnosis ◽  
Anterior Mediastinum ◽  
Small Cell ◽  
Common Symptom ◽  
Small Cell Neuroendocrine Carcinoma ◽  
X Ray ◽  
Chest X Ray ◽  
Slow Growing

We report the case of an elderly man who had visited many physicians with breathlessness and was treated in an outpatient care. The cause of breathlessness was not evaluated, which turned out to be a slow-growing tumour in the mediastinum. Later, we diagnosed it to be a case of neuroendocrine carcinoma arising from the anterior mediastinum. The patient had succumbed to death because of the delayed diagnosis. A simple chest X-ray could have helped to make an early diagnosis. This case is reported with the intention to bring into light the effect of delayed diagnosis of a rare disease presenting with a very common symptom.

scholarly journals Does Negative Immediate Postprocedure Chest CT Obviate the Need for Delayed Chest X-ray in Patients Undergoing CT-Guided Needle Lung Biopsies

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 467A
Author(s):  
Essam Mekhaiel ◽  
Nancy Munn ◽  
Shadi Obeidat ◽  
Shadi Badin ◽  
Gress Todd
Keyword(s):  
Chest Ct ◽  
Ct Guided ◽  
X Ray ◽  
Chest X Ray ◽  
Lung Biopsies

scholarly journals Sarcoidosis - A Case Report

2019 ◽  
Vol 10 (1) ◽  
pp. 92-95
Author(s):  
Md Safiqul Islam ◽  
Md Mahmudur Rahman Siddiqui
Keyword(s):  
Cervical Lymphadenopathy ◽  
Symptomatic Treatment ◽  
Lymph Node Biopsy ◽  
Unknown Etiology ◽  
Healthy Life ◽  
X Ray ◽  
Medical College ◽  
Node Biopsy ◽  
Chest X Ray ◽  
Granulomatous Disorder

Sarcoidosis is a chronic granulomatous disorder of unknown etiology, commonly affecting the lungs, skin and eyes. Although lungs and lymph nodes are involved in more than 90% of patients, virtually any organ can be involved. We describe a 36 years old lady presented with fever, skin rashes, cough, polyarthralgia, bodyache, wt. loss for 3 months. Examination revealed Fever, Erythema Nodosum, Cervical Lymphadenopathy. Investigations revealed high ESR (80 mm in 1st hour), high CRP, Hilar Lymphadenopathy on Chest X ray, Non-caseous Granuloma, Giant cell and Asteroid body on Lymph node Biopsy. All of her history, clinical examinations and Investigations are suggestive of Sarcoidosis. With symptomatic treatment and watchful observation, now she is completely symptoms free and leaving a healthy life. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 92-95

Is There a Role for Secondary Thoracic Ultrasound in Patients with Penetrating Injuries to the Anterior Mediastinum?

2008 ◽  
Vol 74 (1) ◽  
pp. 11-14
Author(s):  
Jon D. Simmons ◽  
A. Neal Haraway ◽  
Robert E. Schmieg ◽  
Michael Burgdorf ◽  
Juan Duchesne
Keyword(s):  
Anterior Mediastinum ◽  
Pericardial Tamponade ◽  
Thoracic Injury ◽  
Delayed Presentation ◽  
Penetrating Injuries ◽  
Thoracic Ultrasound ◽  
X Ray ◽  
Initial Injury ◽  
Chest X Ray ◽  
Timely Fashion

Pericardial tamponade (PT) after penetrating thoracic injury can be lethal if not diagnosed and treated promptly. Most patients present with PT shortly after their injuries occur, but delayed presentation of PT (delayed pericardial tamponade [DPT]) has occurred as late as 73 days after initial injury. Initial evaluation of patients with an anterior mediastinal penetrating injury includes physical examination, chest x-ray, and echocardiography. CT scans of the chest can clarify the tracts of penetrating injuries in stable patients. With increased accessibility to these radio-graphic modalities, PT has been diagnosed in a more timely fashion, and the incidence of DPT has decreased. However, the absence of pericardial effusions on all of these studies at initial presentation does not clear the patient from risk for developing DPT.

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