ABSTRACT
Complete tracheal agenesis is a very rare congenital anomaly that is only compatible with life in some cases with associated tracheo-oesophageal or broncho-oesophageal fistula. In most cases, concomitant congenital anomalies of the heart, digestive tract or genitourinary tract are present. It should be suspected in any neonate with a history of hydramnios, absent crying, respiratory distress and difficulty in intubation. The possibility for surgical correction or palliation rests on the extent of atresia present. We present a case of complete tracheal agenesis without tracheo nor broncho-oesophageal fistula (type II by Floyd's classification) - the diagnosis of which was prenatally suspected - and discuss the important features of the airway management of this condition.
Subject(s)
Trachea/abnormalities , Abnormalities, Multiple , Adult , Amniocentesis , Amniotic Fluid/chemistry , Crying/physiology , Female , Humans , Infant, Newborn , Intubation, Intratracheal , Laryngoscopy , Male , Palliative Care , Phospholipids/analysis , Polyhydramnios/complications , Pregnancy , Respiratory Distress Syndrome, Newborn/etiology , Trachea/diagnostic imaging , Trachea/embryology , Trachea/surgery , Ultrasonography, PrenatalABSTRACT
BACKGROUND AND OBJECTIVES: Single ventricle is a complex congenital cardiopathy characterized by a unit ventricular chamber. Changes of the cardiovascular system in response to epidural anesthesia in these patients have yet to be clearly elucidated. METHODS: A 26-year-old man with single ventricle underwent an orchiopexy under lumbar epidural anesthesia with intravenous sedation. RESULTS: Orchiopexy was successfully performed and the patient was discharged from hospital 4 days later. CONCLUSION: This case report emphasizes the issues of importance to anesthesiologists in regard to this cardiopathy and describes a successful technique of caring for a patient with a complex problem in an emergency situation.
Subject(s)
Anesthesia, Epidural , Heart Ventricles/abnormalities , Spermatic Cord Torsion/surgery , Adjuvants, Anesthesia/administration & dosage , Adult , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Cardiomegaly/physiopathology , Conscious Sedation , Fentanyl/administration & dosage , Heart Block/physiopathology , Humans , Hypnotics and Sedatives/administration & dosage , Injections, Intravenous , Length of Stay , Lidocaine/administration & dosage , Male , Midazolam/administration & dosage , Transposition of Great Vessels/physiopathologySubject(s)
Brachial Plexus , Myasthenia Gravis/physiopathology , Nerve Block , Aged , Cloxacillin/adverse effects , Female , Humans , Mepivacaine/administration & dosage , Myasthenia Gravis/complications , Nerve Block/adverse effects , Respiratory Insufficiency/etiology , Stress, Physiological/complications , Stress, Physiological/physiopathologyABSTRACT
We describe a case of a patient subjected to what proved to be an epidural puncture with catheter placement resulting in persistent unilateral analgesia. The epidurographic study by contrast medium injection through the catheter showed unilateral distribution of the contrast following the cranio-caudal axis in the anterior epidural space.