Paraplegia after Gastrectomy in a Patient with Cervical Disc Herniation: A Case Report and Review of Literature

Abstract

Paraplegia is a rare postoperative complication. We present a case of acute paraplegia after elective gastrectomy surgery because of cervical disc herniation. The 73-year-old man has the medical history of cervical spondylitis with only symptom of temporary pain in neck and shoulder. Although the patient's neck was cautiously preserved by using the Discopo, an acute paraplegia emerged at about 10 hours after the operation. Severe compression of the spinal cord by herniation of the C4-C5 cervical disc was diagnosed and emergency surgical decompression was performed immediately. Unfortunately the patient showed limited improvement in neurologic deficits even after 11 months.

Airway management for a patient with tracheobronchomegaly undergoing lobectomy: a case report

“…Another strategy to provide OLV is inserting an endotracheal tube (ETT) into the dependent bronchus. Considering that the low-pressure cuff has a lower risk of mucosal injury even applying increased volume of air to the cuff, this seems to be a better choice for patients with TBM [ 7 , 8 ]; however, it should be noted that for a patient with TBM, the cuff site will be very inclined to be dilated and subsequently narrowed due to the fibrous tissue formation. It was thus suggested that intubation the trachea with an uncuffed tube together with throat packing to reduce the risk of gas leakage and aspiration [ 5 ].…”

“…Tracheobronchomegaly (TBM) first described by Mounier Kuhn in 1932 [ 1 ] is a very rare disorder characterized by marked tracheobronchial dilation and flaccidity with diverticularization from the severe atrophy of elastic fibers with thinning of the muscularis mucosa in the central airway [ 2 – 4 ] .The airway management of a patient with TBM can be challenging and more complex for one-lung ventilation (OLV). To the authors’ knowledge, very few cases with TBM receiving OLV were reported [ 5 – 8 ]. Here, the authors presented a patient with TBM receiving left lower lobectomy.…”