Pheochromocytoma found during Transurethral Resection for Bladder Tumor - A case report / 대한마취과학회지

Unsuspected pheochromocytoma in a surgical patients may lead to serial complications. These include extreme hypertension, taehycardia and cardiac arrythmias which lead to cardiac arrest, cerebrovascular accident and renal failure in the postoperative period. Pheochromocytoma arising in the urinary bladder is a rare tumor. We recently experienced a case of pheochromocytoma which was found during transurethral resection for biopsy of bladder tumor under spinal anesthesia. The blood pressure suddenly rose during resection. of the tumor. It was difficult to arrive at a correct diagnosis in this case because of the predominant bladder symptams without hypertenaive attack. Therefore, final diagnosis was made as the pheochromocytoms after histological examination. The resection of the tumor was performed under general anesthesia after careful studies. The patient was not treated during the preoperative period as she had no particular symptoms, but Regitine was glven during surgery. Regitine was used twice to control the transient hypertension during manipulation of the tumor. After removal of the tumor, the blood pressure was well regulated without vasopressor drugs. We report a case of pheochromocytoma of urinary bladder with successful anesthesia management and the use of neuroleptanesthetics.

A Case of Acute Massive Pulmonary Collapse following Induction of Anesthesia / 대한마취과학회지

This report concerns a child who developed left ; Iung collapse during induction of anesthesia for suture ligation of patent ductus arteriosus. Acute massive collapse of a lobe, a whole lung or even both lungs in the space of a few minutes without apparent cause is said to be a rare elinical entity. Clinically this condition is manifested by difficulty in breathing or in inflation of the lung. On auscultation, there may be rhonchi or no sound of any air entry into the lung. If unrelieved, this condition will progress, with hypoxia and cardiac arrest. " We observed that the affected lung expanded during inflation with very high pressure ventilation, and then the collapsed lung was smoothly inflated after suture ligation of patent ductua arteriosus without any specific management. It appears that the development of lung collapse is not through the wrong choice of agents or technics of anesthesia, but from failure to appreciate the hemodynamics of ductus arteriosus or unknown factors. We could not find a definite mechanism of lung collapse, but there are contributing factors including compression of a main brobchus, bronchial secretion, decrease of surfactant and others. The operation was successful and she recovered satisfactorily.