A pediatric patient with a mediastinal mass and pulmonary embolus.
When anesthetizing a patient with an anterior mediastinal mass, sudden hypoxaemia and cardiovascular collapse may result from compression of a large airway or vascular structure in the mediastinum. We report the case of a pediatric cancer patient with an anterior mediastinal mass, who developed sudden and fatal hypoxaemia and cardiovascular collapse in the hours following sedation. A massive pulmonary thromboembolism was diagnosed at autopsy. We suggest that pulmonary embolism should be considered in the differential diagnosis when a patient with a mediastinal mass develops perioperative hypoxaemia, cardiovascular collapse, or both.
Burgoyne
Laura L
LL
Division of Anesthesiology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. laura.burgoyne@stjude.org
Anghelescu
Doralina L
DL
Tamburro
Robert F
RF
De Armendi
Alberto J
AJ
D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology; D002648:Child; D017809:Fatal Outcome; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000473:pathology; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000150:complications* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014692:Ventilation-Perfusion Ratio / Q000502:physiology