Anesthetic management of a patient with Alport-leiomyomatosis syndrome.
We report the anesthetic management of esophagectomy for a patient with Alport-leiomyomatosis syndrome. A 23-year-old woman complained of dysphagia and severe chest pain. Her chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) showed an enlarged esophagus, in contact with the trachea, heart, aorta, and large vessels. She frequently experienced severe asthma attacks. Because various risks in both respiration and circulation, especially in anesthesia induction, were of concern, her right femoral vessels were exposed, for the emergency use of percutaneous cardiopulmonary support (PCPS), prior to anesthesia induction. Anesthesia was induced and maintained with propofol, fentanyl, and vecuronium. Esophagectomy was performed uneventfully and no severe events were seen in anesthesia management. Alportleiomyomatosis syndrome is a very rare disease. When we are involved in the anesthetic management of a patient with this disease, evaluation of the influence of the enlarged esophagus on both respiration and circulation, and careful preparation for emergence, are very important.
Hanazaki
Motohiko
M
Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Takata
Ken
K
Goto
Keiji
K
Katayama
Hiroshi
H
Yokoyama
Masataka
M
Morita
Kiyoshi
K
Shirakawa
Yasuhiro
Y
Yamatsuji
Tomoki
T
Naomoto
Yoshio
Y
D000768:Anesthesia, General; D001249:Asthma / Q000150:complications; D004938:Esophageal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D016629:Esophagectomy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D018231:Leiomyomatosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D055815:Young Adult
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