Emergency surgery for acute respiratory failure secondary to spontaneous thyroid hemorrhage.
A 42-year-old woman was evaluated for an emergency at our surgical department for acute dyspnea associated with a spontaneous and rapidly enlarging mass of the neck. Clinical examination revealed a large, firm, nonfluctuant thyroid swelling on the right side of the neck. An urgent computerized tomography scan showed a hematoma within the right lobe of the thyroid and tracheal deviation with marked luminal narrowing. Because of the rapid progression of respiratory distress, endotracheal intubation by flexible laryngoscopy revealing normal vocal cords function and emergency total thyroidectomy were performed. During the operation, the thyroid gland showed a huge, edematous, nonfluctuant, rubbery, firm swelling with easy bleeding on touch, but the capsule appeared to be intact without rupture. Microscopic examination revealed a colloid multinodular goiter with massive parenchymal hemorrhage. Recovery was uneventful, and the patient was discharged 2 days after the operation.
Testini
Mario
M
Section of General and Thoracic Surgery, Department of Applications in Surgery of Innovative Technologies, University Medical School of Bari, Bari, Italy. mario.testini@tin.it
Gurrado
Angela
A
Lissidini
Germana
G
Lardo
Domenica
D
Poli
Elisabetta
E
Piccinni
Giuseppe
G
D000328:Adult; D003287:Contrast Media; D005260:Female; D006470:Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000601:surgery*; D013959:Thyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media