[Mediastinal tumor and airway obstruction in general anesthesia. Case report and review of the literature].
Case report of an acute airway obstruction during general anaesthesia by compression of the left main bronchus in an asymptomatic patient with unknown mediastinal mass. The patient was scheduled for a relief of a thyroid gland cyst. The compression occurred after uneventful induction of anaesthesia during the patient's positioning with flexed neck and elevated upper thorax on a pad. Increasing FiO2 from 0.5 to 1.0, repeated fiberoptic bronchoscopic examination and changing of the position of the endotracheal tube facilitated the operation. After reversal of the flexed neck position ventilation was normal. The intraoperatively suspected mediastinal tumour was confirmed by postoperative computerised tomography of thorax and neck. The teratoma was removed in toto in a second operation. In a review of the literature pathophysiological changes, preoperative assessment and anaesthetic management of patients with mediastinal tumour are discussed.
Stamme
C
C
Abt. Anästhesiologie II, Medizinische Hochschule Hannover.
Lübbe
N
N
Mahr
K H
KH
Dralle
H
H
Karck
M
M
D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000768:Anesthesia, General; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016683:Supine Position; D013724:Teratoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
Mediastinaltumor und Luftwegsobstruktion unter Allgemeinanästhesie. Fallbeispiel und Literaturüberblick.