SummarySuperior vena caval obstruction from a mediastinal mass presents a significant risk to patients requiring general anaesthesia, with reports of sudden death on induction of anaesthesia, during intubation and on initiation of positive pressure ventilation. We describe the first reported use of temporary extracorporeal jugulosaphenous bypass in three cases of superior vena caval obstruction and extrinsic tracheal compression caused by massive retrosternal multinodular goitre. The bypass was performed before induction of general anaesthesia with consequent reduction in upper body venous pressure and avoidance of complications.
The hypothesis proposed by these two cases is that patients with chronic renal failure on dialysis have an increased likelihood of developing multifocal papillary carcinoma of the thyroid. Two rare conditions can occur synchronously but is there a true association? Have any of our readers observed a similar relationship? Enigmas & Hypotheses Chronic renal failure: another complication of this interminable condition? NICHOLAS RF LAGATTOLLA
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