Peri-Operative Management of a Patient with Bilateral Giant Bullae and Pneumothorax in the Context of Severe Pulmonary Obstructive Disease

Endou, Masato; Yasuhira, A.; Nishiyama, Katsura; Kodaka, Mitsuharu; Mae, Masahiro; Komori, Makiko

doi:10.4172/2155-6148.1000162

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Therefore, although CSEA had been planned, it was altered based on the patient’s respiratory status. Extracorporeal circulation is reported to be necessary in cases where intubation or positive-pressure ventilation was predicted to be difficult [ 7 , 8 ]. Although the situs inversus could make the cannulation difficult, it was performed without difficulty by the cardiologists using portable ultrasound and X-ray.…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of a pregnant patient with mediastinal tumor complicated by tuberculosis

et al. 2017

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Mediastinal tumor in a pregnant woman, which had needed a multidisciplinary approach, was further complicated by tuberculosis. The clinical course of the current patient was very complicated. A 37-year-old female at 18 weeks of gestation with a mediastinal tumor was referred to our hospital due to dyspnea and orthopnea. The tumor compressed the left main bronchus causing bronchial stenosis. She was diagnosed with primary mediastinal large B-cell non-Hodgkin’s lymphoma. Delivery after 24 gestational weeks with ongoing chemotherapy was planned by a multidisciplinary team comprising obstetricians, anesthesiologists, neonatologists, and hematologists. Her symptoms improved with chemotherapy; however, she was later diagnosed with tuberculosis leading to chemotherapy interruption to treat tuberculosis. The following confirmation by negative sputum smear microscopy, an elective cesarean section with spinal anesthesia was performed at 33 weeks of gestation, and she safely delivered a female infant. At postoperative day 23, she died due to cardiopulmonary arrest, following an irreversible coma subsequent to brain metastasis of malignant lymphoma. The infant died of respiratory failure at postoperative day 18. This case illustrates several implications, such as the necessity of a thorough systemic examination and treatment approaches for mothers and neonates with suspected tuberculosis during the perioperative period, for considering similar cases with neoplasms.

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Section: Discussionmentioning

confidence: 99%