Cases reported "Goiter"

Filter by keywords:



Filtering documents. Please wait...

1/34. Large goitre causing difficult intubation and failure to intubate using the intubating laryngeal mask airway: lessons for next time.

    A 63-yr-old woman was anaesthetized for sub-total thyroidectomy. The thyroid gland was large, deviating the trachea to the right and causing 30% tracheal narrowing at the level of the suprasternal notch. Mask ventilation was easy but laryngoscopy was Cormack and Lehane grade 3. Despite being able to see the tip of the epiglottis, tracheal intubation was impossible. An intubating laryngeal mask was inserted and although the airway was clear and ventilation easy, it was not possible to intubate the trachea either blindly or with the fibreoptic bronchoscope. Tracheal intubation was eventually achieved using a 6.5-mm cuffed oral tracheal tube via a size 4 laryngeal mask under fibreoptic control. We describe the case in detail and discuss the use of the intubating laryngeal mask, its potential limitations and how to optimize its use in similar circumstances.
- - - - - - - - - -
ranking = 1
keywords = airway
(Clic here for more details about this article)

2/34. Goitre presenting as an oropharyngeal mass: an unusual finding in the elderly.

    Thyroid goitre presentation in the neck with extension inferiorly to the mediastinum is well-known. Extension superiorly into the retropharyngeal space is very rare and may be accompanied by change in voice and/or airway compromise. A case is described of a patient with change in voice and mild airway compromise secondary to a goitre presenting in the oropharynx. Computed tomography (CT) and physical findings are discussed with the need to recognize this rare entity.
- - - - - - - - - -
ranking = 0.4
keywords = airway
(Clic here for more details about this article)

3/34. Management of a pregnant patient with airway obstruction secondary to goitre.

    A case of airway obstruction in advanced pregnancy is presented. The patient was successfully managed with an awake fibreoptic intubation performed orally followed by a caesarean section and thyroidectomy as a combined procedure. On resection, a thyroid gland weighing 370 g was removed. The patient made an uneventful recovery.
- - - - - - - - - -
ranking = 22.328420626282
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

4/34. amyloid goiter with parathyroid involvement: a case report and review of the literature.

    Although involvement of the thyroid gland by amyloid is a relatively common phenomenon, diffuse enlargement of the gland secondary to infiltration by amyloid is infrequent. We report the pathologic findings in a case of primary amyloid goiter with involvement of a parathyroid gland in an euthyroid patient who presented to his physician with an enlarged thyroid, upper airway obstructive symptoms, and dysphagia. The clinical features of amyloid goiter, including difficulties in preoperative diagnosis and management, are discussed.
- - - - - - - - - -
ranking = 0.2
keywords = airway
(Clic here for more details about this article)

5/34. Neonatal goiter caused by expectorant usage.

    A female newborn was admitted with the symptoms of mild respiratory distress, protruding tongue, hypotonicity, cutis marmorata, sclerema, myxedema, abdominal distension, and feeding problems on the first day of life. She had a huge neck mass, a large anterior and posterior fontanel, and hoarse cry. She had no umbilical hernia or jaundice. A history of maternal potassium iodine (expectorant) usage without doctor's advice was obtained; the mother had not attended a clinic throughout the pregnancy. On ultrasonographic examination, the thyroid right lobe was 53 x 31 mm and the left lobe was 34 x 31 mm. The results of thyroid hormone tests on the first day were as follows: T3 20 ng/dl (normal: 32-216 ng/dl), T4 0.9 microg/dl (11.8-22.6 microg/dl), TSH 120 mIU/l (2.5-13.3 mIU/l). This patient is presented to emphasize the role of hypothyroidism in drug-induced neonatal goiter and to discuss the possibility of a life-threatening effect of congenital goiter, i.e. respiratory tract obstruction.
- - - - - - - - - -
ranking = 0.12034329512081
keywords = obstruction
(Clic here for more details about this article)

6/34. Clinical case seminar: Riedel's thyroiditis: report of a case complicated by spontaneous hypoparathyroidism, recurrent laryngeal nerve injury, and Horner's syndrome.

    A 42-yr-old woman presented with hyperthyroidism and a large, firm, irregular goiter. Within a few weeks she became hypothyroid. Five months later she developed increasingly severe neck pain and compressive symptoms. The goiter had become rock hard. A fine needle aspiration biopsy showed features of chronic thyroiditis and fibrosis. She partially responded to a course of glucocorticoids. tamoxifen was added, with marked improvement in goiter size and pain. Both medications were tapered off. Two months later the patient experienced paresthesias of the fingertips, perioral numbness, and a seizure. She was found to have spontaneous primary hypoparathyroidism. Three months later the patient became hoarse and experienced difficulty in breathing. She was found to have a massively enlarged thyroid with compression of the right internal jugular vein and encasement of the right carotid artery as well as tracheal narrowing. She also had right vocal cord paralysis due to recurrent laryngeal nerve involvement. Because of airway compromise, an emergency isthmusectomy was performed, and the patient was given a postoperative course of glucocorticoids with gradual improvement. Postoperative diagnosis was Riedel's thyroiditis. Two months later she presented with near-syncope and was found to have bradycardia, hypotension, and right Horner's syndrome, presumably due to compression of the right carotid sheath. She was given i.v. glucocorticoids and tamoxifen. Six months later and 18 months after her initial presentation, the patient is doing remarkably well. Her goiter has regressed by more than 50%, and she no longer has any pain or difficulty breathing. She remains a little hoarse and has persistent hypothyroidism and hypoparathyroidism. She is taking prednisone (5 mg, this is being tapered very slowly) and tamoxifen (20 mg) daily. This case illustrates the protean manifestations of Riedel's thyroiditis, a rare but fascinating disease. The epidemiology of this disease, its pathophysiology and complications, and the roles of surgery and medical therapy are reviewed.
- - - - - - - - - -
ranking = 0.2
keywords = airway
(Clic here for more details about this article)

7/34. liposarcoma of the thyroid gland mimicking retrosternal goiter.

    Primary liposarcoma of the thyroid gland is extremely rare with only two previous reports in the literature. We report two further cases, both patients presenting with rapid airways compression. Patient 1 had clinical, radiographic, and biopsy appearances suggesting benign goiter. Patient 2 had a long-term history of benign goiter, a previous partial thyroidectomy, and more recent biopsies showing liposarcoma. The management of such rare conditions is always challenging.
- - - - - - - - - -
ranking = 0.2
keywords = airway
(Clic here for more details about this article)

8/34. sarcoidosis confined to the airway masquerading as asthma.

    A rare case of sarcoidosis is presented. A 32-year-old white woman initially diagnosed with asthma was to undergo thyroidectomy to eliminate what was thought to be the real source of her symptoms. Instead, the cause was found to be sarcoidosis involving only the major airways, without intrathoracic adenopathy, atelectasis, pulmonary parenchymal infiltrates or evidence of extra pulmonary disease. She rapidly responded to systemic glucocorticoids, which later was supplemented successfully by inhaled glucocorticoids for persistent cough.
- - - - - - - - - -
ranking = 1
keywords = airway
(Clic here for more details about this article)

9/34. Neck haematoma and airway obstruction in a patient with goitre: complication of internal jugular vein cannulation.

    Attempted jugular vein cannulation in a patient with a discrete goitre resulted in a rapid growing haematoma and airway obstruction. This life-threatening complication is rare, and is usually related to two conditions: pre-existing coagulopathy and/or arterial puncture by a large bore cannula or vessel dilator. None of these was present in this patient. Investigations revealed a retrosternal goitre causing tracheal compression and major changes in the calibre and the anatomical relationships of neck vessels. Possible origin and mechanism for the sudden haematoma are discussed, as well as the airway management. This case clearly illustrates how internal jugular vein cannulation using the traditional blind technique, guided by external landmarks, can be extremely hazardous in patients with distorted anatomy of the neck.
- - - - - - - - - -
ranking = 22.528420626282
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

10/34. Fetal hydrops, associated with maternal propylthiouracil exposure, reversed by intrauterine therapy.

    Thyroid hormone is essential for fetal neurological development. Among other etiologies, fetal hypothyroidism may be caused by maternal exposure to antithyroid drugs (ATDs). The most common presentation of fetal hypothyroidism is fetal goiter, which can cause dystocia, in addition to airway obstruction in the neonate. Intra-amniotic treatment with levothyroxine normalizes fetal thyroid status and reduces goiter size. We present a case of fetal hypothyroidism diagnosed in a patient who was treated with propylthiouracil (PTU) for Grave's disease. The fetus had marked hydrops fetalis and a large goiter. In addition, anal stenosis, vesicovaginal fistula, bilateral pyelectasia and polydactyly were diagnosed in the neonate. Intra-amniotic treatment with levothyroxine resulted in a regression of the hydrops and a reduction in the goiter size. A euthyroid, non-edematous, non-goitrous neonate was delivered. At the age of 27 months the child's psychomotor development was normal. The present case indicates that hydrops fetalis may be an unusual manifestation of fetal hypothyroidism, caused by intrauterine exposure to maternal antithyroid drugs (ATDs), and that it may be resolved by treatment with intra-amniotic levothyroxine.
- - - - - - - - - -
ranking = 4.4656841252565
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)
| Next ->


Leave a message about 'Goiter'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.