Extreme pectus excavatum with sterno-dorsal apposition, levocardia, and right lung atelectasis: successful repair using the Humpreys-Connolly techniques

An extreme case of pectus excavatum with sterno-dorsal "kissing", axaggerated levocardia, and right lung atelectasis is described in an eight-year old male. Successful surgical repair without internal or external fixation was done utilizing the ingenious Humphreys-Connolly technique. The initial two-month follow-up is satisfactory. The technique is described and rationalizedThe case is correlated with previous experiences regarding hemodynamic, cardiologic, and respiratory alterations and their bearing on surgical results. (Summary)

Hypoxemia due to Obstruction of the Main Bronchus during Spinal Anesthesia in Patient with Bronchiectasis / 대한마취과학회지

A 75-year-old male patient with a left intertrochanteric fracture underwent emergency total hip arthroplasty under spinal anesthesia. He had an operation for laryngeal cancer about 10 years ago. Bronchiectasis and atelectasis were noticed in his preoperative roentgenogram. He underwent spinal anesthesia with 13 mg of 0.5% isobaric tetracaine. The level of spinal anesthesia was T7. The SpO2 (oxygen saturation of pulse oxymeter) decreased to 55% at 1 hour after start of operation. Breath sounds on the right lung were diminished. Tracheal intubation was performed for endotracheal suction. A large amount of yellowish secretion was aspirated through suction catheter. The SpO2 returned to 98%. We report a case of severe hypoxemia due to inability of expectoration in patient with bronchiectasis who underwent spinal anesthesia.

Atelectasis of Right upper Lobe after Left Thoracotomy under General Inhalation Anesthesia / 대한마취과학회지

Pulmonary atelectasis is a common complication following surgery under general anesthesia. However, collapse during anesthesia and surgery is rare, and usually is not diagnosed until the surgical procedure is well under way. Total or segmental lung collapses are usually resulted from the obstruction of bronchial pathway by secretions such as mucus, blood and pus etc. We experienced acute lung collapse of right upper lobe during left thoracotomy. We assumed that the cause of the atelectasis was an obstruction of right superior lobar bronchus by mucus. The possible cause of lung collapse is described.