ABSTRACT
La amiloidosis comprende un grupo de trastornos que se distinguen por el depósito de agregados fibrilares de inmunoglobulinas monoclonales de cadenas ligeras en diversos órganos, entre ellos, la laringe. A continuación presentamos el caso de un varón de 78 años derivado a nuestro hospital para tratamiento quirúrgico de una hernia umbilical estrangulada. El paciente presentaba disfonía y disfagia de 5 meses de evolución debido a la presencia de una amiloidosis laríngea. Se decidió realizar la intubación con el paciente despierto, sedado con remifentanilo y midazolan, utilizando el videolaringoscopio King Vision®. Las lesiones hemorrágicas que pueden acontecer en estos pacientes son debidas al depósito de agregados fibrilares de amiloide, que causan una fragilidad vascular que aumenta el riesgo de hemorragia durante la intubación. Por eso es importante que el anestesiólogo realice un cuidadoso manejo de la vía aérea en pacientes con esta entidad (AU)
Amyloidosis is a term that involves a group of diseases characterised by deposition of extracellular monoclonal light-chain fibrillar immunoglobulin aggregates in the body, including many organs, with the larynx among them. A case is presented of a 78 year-old man who was referred to our institution for strangulated umbilical hernia treatment. He suffered from progressive hoarseness and dysphagia for 5months. He had a history of primary laryngeal amyloidosis. Awake intubation was performed successful with the King Vision® video-laryngoscopy. Sedation was achieved using a remifentanil infusion and midazolam. Haemorrhagic lesions are caused by deposition of amyloid in and around vessels, resulting in increased vascular fragility. Therefore, anaesthetists should take care in intubating the tracheas of these patients (AU)
Subject(s)
Humans , Male , Aged , Amyloidosis/complications , Laryngostenosis/complications , Laryngoscopy/methods , Hernia, Umbilical/surgery , Anesthesia/methods , Airway Management/methods , Intubation, Intratracheal/methods , Video-Assisted Surgery/methods , Conscious Sedation/methodsABSTRACT
Amyloidosis is a term that involves a group of diseases characterised by deposition of extracellular monoclonal light-chain fibrillar immunoglobulin aggregates in the body, including many organs, with the larynx among them. A case is presented of a 78 year-old man who was referred to our institution for strangulated umbilical hernia treatment. He suffered from progressive hoarseness and dysphagia for 5months. He had a history of primary laryngeal amyloidosis. Awake intubation was performed successful with the King Vision® video-laryngoscopy. Sedation was achieved using a remifentanil infusion and midazolam. Haemorrhagic lesions are caused by deposition of amyloid in and around vessels, resulting in increased vascular fragility. Therefore, anaesthetists should take care in intubating the tracheas of these patients.
