Complications with massive sacrococcygeal tumor resection on a premature neonate.
Resection of large sacrococcygeal teratomas (SCT) in neonates can pose many anesthetic challenges. The pathophysiology of the SCT determines the varying management. We present a case report of a 34-week newborn with a massive Altman type 3 SCT. The surgery was delayed 2 days because of hyperkalemia; however, as a result of continued tumor lysis the patient's condition had worsened with little improvement of the potassium level. During the surgery, the patient had issues of bleeding needing massive transfusion. Ventilation was also difficult at times because of the massive tumor resting on the chest, resulting in respiratory acidosis. We also had difficulty in maintaining the temperature. This patient did well after the surgery and was discharged home. We address here the anesthetic issues involved in the perioperative care management of a premature infant with a massive SCT.
Department of Pediatric Anesthesiology and Pain Medicine, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Slot 203, Little Rock, AR 72202, USA. abrahamedwinj@uams.edu
Edwin
E
Abraham
Tariq
T
Parray
Abid
A
Ghafoor
D000138:Acidosis; D001034:Apgar Score; D001794:Blood Pressure / Q000502:physiology; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000150:complications; D007231:Infant, Newborn; D007234:Infant, Premature; D007431:Intraoperative Complications / Q000628:therapy; D019990:Perioperative Care; D011188:Potassium / Q000097:blood; D012445:Sacrococcygeal Region / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000601:surgery*; D013724:Teratoma / Q000601:surgery*
D011188:Potassium