Preventing the Catastrophe: Aberrant Carotid in Adenoid and Tonsil Surgery: Two Case Reports

2021 ◽  
Vol 03 ◽  
Author(s):  
Irshad M. Mohiuddin ◽  
Sajid Burud ◽  
Mayank Vats ◽  
Deepa Vats
Keyword(s):  
Surgical Procedures ◽  
Case Reports ◽  
Upper Airway ◽  
Massive Bleeding ◽  
Pharyngeal Airway ◽  
Life Threatening ◽  
Tonsil Surgery ◽  
Endoscopic Assessment ◽  
Carotid Vessels ◽  
Aberrant Vessels

Background: Adenoid and tonsil surgeries are the most commonly done surgical procedures, with haemorrhage being an important complication. Fatalities due to haemorrhage almost never occur, but the occasional devastating outcomes that are life-threatening become a frequent source of litigations and audits. Catastrophic bleeds are usually due to an aberrant vessel or carotid protruding in the pharyngeal airway. The aberrant carotid poses a risk during routine pharyngeal surgeries like adenoidectomy, tonsillectomy, Quincy and Para-pharyngeal abscess drainage, UPPP, pharyngeal biopsies, etc. and injuries during routine pharyngeal surgical procedures can be catastrophic due to massive bleeding. Case report: We report two cases of routine Adeno-tonsillectomy surgeries where aberrant carotid vessels protruding in the adeno-tonsil surgical area were identified by endoscopic transoral evaluation intraoperatively. The surgery in these cases was postponed for further investigation due to the risk of injury and catastrophic bleeding. Conclusion: Aberrant carotids are usually clinically silent, and adenoid removal in most cases is a blind procedure done by curettage. There are no guidelines to identify aberrant vessels pre or intraoperatively, and preventing injury and catastrophic bleeding depends on surgeon’s experience and caution. These cases underline the importance of due vigilance and taking steps before starting the procedures, particularly pre-and intraoperative transoral endoscopic assessment for identifying aberrant vessels in the upper airway area, thus preventing injury and avoiding devastating complications. We report these cases and underline the steps to identify aberrant vessels in the upper airway surgical field before starting surgery to prevent a potentially catastrophic complication.

Nebulized Adrenaline in the Postoperative Management of Brachycephalic Obstructive Airway Syndrome in a Pug

2017 ◽  
Vol 53 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Jenny Ellis ◽  
Elizabeth Ann Leece
Keyword(s):  
Quality Of Life ◽  
Airway Obstruction ◽  
Surgical Procedures ◽  
Postoperative Period ◽  
Upper Airway ◽  
Postoperative Management ◽  
Laryngeal Edema ◽  
Life Threatening ◽  
Tracheostomy Tubes

ABSTRACT Brachycephalic obstructive airway syndrome is a common problem in certain breeds, and may necessitate surgical procedures, such as rhinoplasty, palatoplasty, laryngeal sacculectomy, and/or arytenoid laryngoplasty, to improve the quality of life. However, laryngeal edema may necessitate the use of temporary tracheostomy tubes postoperatively to maintain a patent airway. This case demonstrates that administration of nebulized adrenaline in the immediate postoperative period where upper airway obstruction is life threatening can be used to reduce edema, therefore avoiding the need for tracheostomy.

A dangerous cause of airway obstruction: deep neck infection

2020 ◽  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Deep Neck Infection ◽  
Jugular Vein Thrombosis ◽  
Neck Infection ◽  
Vein Thrombosis ◽  
Lethal Complications ◽  
Life Threatening ◽  
Fascial Spaces ◽  
Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

scholarly journals Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692110059
Author(s):  
Michal Vlasin ◽  
Richard Artingstall ◽  
Barbora Mala
Keyword(s):  
Airway Obstruction ◽  
Clinical Signs ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Single Session ◽  
Inflammatory Polyp ◽  
Case Summary ◽  
First Case ◽  
Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

scholarly journals Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi
Keyword(s):  
Orthodontic Treatment ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Lower Airway ◽  
Control Group ◽  
Maxillary Expansion ◽  
Pharyngeal Airway ◽  
Significant Difference ◽  
And Gender ◽  
Maxillary Constriction

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group ( mm) compared to the control group ( mm), . However, there was no significant difference in the lower pharyngeal airway measurement between the RME group () and the control group (), . There was no significant difference with respect to mode of breathing between the two groups (). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.

scholarly journals Valproate semisodium-induced encephalopathy: diet and polypharmacy interactions

2012 ◽  
Vol 36 (4) ◽  
pp. 137-139 ◽  
Author(s):  
Nuno Rodrigues Silva ◽  
Ângela Venâncio
Keyword(s):  
Case Reports ◽  
Adult Population ◽  
Paediatric Population ◽  
Valproate Semisodium ◽  
Bipolar I Disorder ◽  
Life Threatening ◽  
Life Threatening Complication

SummaryDespite extensive use of valproate in neurology and psychiatry, valproate-induced encephalopathy is a rarely reported complication. Although initially reported in the paediatric population, case reports are growing in the adult population.Clinicians need to be aware of this potentially life-threatening complication. We report a case in a 37-year-old woman with bipolar I disorder with previously uncomplicated valproate use, who developed encephalopathy when valproate was restarted a few years later. The patient has provided consent for publication.

HIV/AIDS and traditional healers: a blessing in disguise

2010 ◽  
Vol 50 (3) ◽  
pp. 154-155
Author(s):  
B L Meel
Keyword(s):  
Case Reports ◽  
Health Care Systems ◽  
Traditional Healers ◽  
Immunodeficiency Virus ◽  
Herbal Decoction ◽  
Care Systems ◽  
Life Threatening ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Traditional healers contribute significantly to the level of health-care systems in Africa. They could play an important role in the prevention and care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the community. The traditional healing system deals with psychosocial stress associated with HIV/AIDS as well as herbal medications. Sometimes, herbal medicine causes serious life-threatening complications. Two case reports are presented in this article. The first is a 48-year-old woman with HIV who was made to drink a large volume of a herbal decoction to stimulate vomiting in the belief that cleansing the bowel would rid the system of the disease. The second is a 25-year-old young man who had a herbal enema, which resulted in gangrene of the large bowel. The case histories, mechanism of action and causes of death are discussed.

Caregivers’ role in managing hereditary angioedema and perceptions of treatment-related burden

2021 ◽  
Vol 42 (3) ◽  
pp. S11-S16 ◽  
Author(s):  
Timothy J. Craig ◽  
Aleena Banerji ◽  
Marc A. Riedl ◽  
Jessica M. Best ◽  
Jinky Rosselli ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Genetic Disease ◽  
Online Survey ◽  
Scientific Literature ◽  
Upper Airway ◽  
The United States ◽  
Care Recipient ◽  
Psychosocial Impacts ◽  
Life Threatening ◽  
Familial Caregivers

Hereditary angioedema (HAE) is a rare genetic disease that results in recurrent, debilitating, and potentially life-threatening swelling episodes in the extremities, genitals, gastrointestinal tract, and upper airway. Patients can experience significant burdens related to their disease. Informal or familial caregivers often support patients with HAE and likely share in the disease-related burdens, although there are limited HAE caregiver‐focused reports in the scientific literature. In the United States, we conducted an online survey of adults caring for an individual with HAE to better understand their experiences with the disease and identify psychosocial impacts of providing care for a patient with HAE. Thirty caregivers provided responses to the survey. Most caregivers were family members of the care recipient and many had HAE themselves. Caregivers reported participating in a number of medical-related tasks and experiencing some burdens as a result of caring for a person with HAE.

A Versatile IBM-Based AMR Method for Studying Human Snoring

2021 ◽  
Author(s):  
Wei Zhang ◽  
Yu Pan ◽  
Yuchen Gong ◽  
Haibo Dong ◽  
Jinxiang Xi
Keyword(s):  
Adaptive Mesh Refinement ◽  
Stokes Equations ◽  
Flow Behavior ◽  
Upper Airway ◽  
Magnetic Resonance Images ◽  
Immersed Boundary ◽  
Cross Sectional ◽  
Pharyngeal Airway ◽  
Aerodynamic Pressure ◽  
Head Neck

Abstract In this work, a local adaptive mesh refinement (AMR) embedded incompressible flow solver is developed for biomedical flows. This AMR technique is based on the block-structured mesh and adapted from an in-house numerical solver for the Navier-Stokes equations with immersed-boundary method embedded, which is suitable for flows with complex and moving boundaries in biomedical applications. Flow behavior of the human upper airway under various head-neck postures is evaluated using the developed AMR technique, where the head-neck posture is hypothesized to change the cross-sectional area of the airway, therefore the airflow and aerodynamic behavior. The anatomically accurate three-dimensional human upper airway model is reconstructed from human magnetic resonance images (MRI) with measurements from the literature. Analyses were performed on vortex dynamics and pressure fluctuations in the pharyngeal airway. It was found that the vortex formation and aerodynamic pressure were affected by the airway bending. The sniffing position or the head-neck junction extension posture tend to facilitate the airflow through the upper human airway.

Sign in / Sign up

Export Citation Format

Share Document