Retrograde Flow of Fluid Through the Nasolacrimal Duct System Under General Anesthesia: A Case Report.

This case report describes a rare incident of fluid exhibiting retrograde flow from the nasopharynx through the nasolacrimal duct and accumulating within the eye guard while under general anesthesia. The patient was in a steep Trendelenburg position for several hours and received multiple liters of intravenous fluid. The patient did not have a history of sinusitis, sinus surgery, cocaine use, dacryostenosis and dacryocystitis, or nasolacrimal duct irrigation and probing. This case provides insight into the potential ophthalmic implications of surgical and anesthetic management. While the patient fortunately had no complications, this case also underscores the importance of intraoperative vigilance.

Acute delayed onset hemodynamic and respiratory compromise due to thoracic translocation of hemourinoma after percutaneous nephrolithotomy.

Percutaneous nephrolithotomy (PCNL) despite its minimally invasive approach has an high complication rate, with the most common complications being extravasation of urine and perioperative bleeding requiring transfusion. While most of these complications are minor, many serious and life-threatening complications do occur. One such complication is the development of hemothorax or hydrothorax which usually develops in the early postoperative period with blood or urine passing from the surgical site through a newly established pleural-peritoneal fistula. Here we describe an unusual presentation and clinical management of delayed onset acute urohemothorax and hemodynamic collapse several days following PCNL.

An unusual cause of airway obstruction in a patient in the endoscopy suite.

A 74-year-old man presented for outpatient endoscopy because of dysphagia and the sensation of a mass in the back of his throat. Esophagogastroduodenoscopy demonstrated a soft tissue mass in the proximal esophagus that prolapsed into the hypopharynx on withdrawal of the endoscope. Complete airway obstruction ensued, requiring emergent tracheotomy. The patient was transferred to the hospital for further treatment. Surgical resection revealed a rare giant fibrovascular polyp, which may be associated with asphyxiation and sudden death.