Anesthetic considerations in steroid-induced mediastinal lipomatosis.
Mediastinal lipomatosis (ML) is a benign condition characterized by circumscribed overgrowth of adipose tissue producing mediastinal widening that can cause errors in diagnosis on chest roentgenogram. We describe a case of steroid-induced ML leading to difficulty in central venous catheterization during surgery and its other implications for anesthesiologists. Because many patients receive long-term steroid administration and present for surgical intervention, it is essential that they undergo detailed preoperative evaluation to exclude Cushing's syndrome and various pressure effects.


CONCLUSIONS
This case report highlights problems during right internal jugular vein cannulation resulting from high back pressure and flow from superior vena cava obstruction in steroid-induced mediastinal lipomatosis. Other anesthetic considerations in mediastinal lipomatosis are also discussed.
Gombar
Satinder
S
Department of Anesthesiology and Critical Care, Government Medical College and Hospital, Sector 32, Chandigarh, India. dr_sgombar@rediffmail.com
Mitra
Sukanya
S
Thapa
Deepak
D
Gombar
Kanti K
KK
Pathak
Richa
R
D000328:Adult; D000768:Anesthesia, General; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D007081:Ileostomy; D008068:Lipomatosis / Q000139:chemically induced* / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008477:Mediastinal Diseases / Q000139:chemically induced* / Q000150:complications* / Q000000981:diagnostic imaging; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D013256:Steroids / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D013256:Steroids; D011239:Prednisolone