[Cesarean section in a patient with threatening hemoptysis caused by tracheal carcinoid].
A woman 29 weeks pregnant presented with acute respiratory insufficiency and massive hemoptysis of unknown origin. An emergency cesarean section was performed to avoid hypoxic fetal damage during episodes of maternal hypoxemia. Bleeding was due to an unsuspected endotracheal carcinoid tumor located near the carina. The tumor obstructed the distal portion of the trachea, leading to life-threatening complications during tracheal intubation because of its histological characteristics and placement. Pulse oximetry response to standard mechanical ventilation was unsatisfactory. Special measures to ventilate mother and fetus were successful, in spite of iatrogenic pneumothorax and pneumomediastinum. We report an exceptional case of tracheal carcinoid tumor during the pregnancy and recommend that tracheal or bronchial intubation take place under fiber optic guidance in cases of hemoptysis with no firm etiologic diagnosis.
Sanchis Mínguez
C
C
Servicio de Anestesiología y Reanimación Hospital Universitario La Fe (Pabellón Central), Avda. Campanar no. 21, 46009 Valencia.
Vela Rubio
A
A
Gosálbez Doménech
J
J
Alepuz Ferrer
R
R
Montero Benzo
R
R
D000328:Adult; D002276:Carcinoid Tumor / Q000150:complications*; D002585:Cesarean Section; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D014134:Tracheal Neoplasms / Q000150:complications*