Related Experiment Videos
Perioperative considerations in a hypothyroid infant with hepatic haemangioma
K P Mason1, B V Koka, E A Eldredge
1Harvard Medical School, Children's Hospital, Department of Anaesthesia, 300 Longwood Avenue, Boston, MA 02115, USA.
Insights
This case study details the perioperative management of a critically ill infant with a rare hepatic hemangioma and severe hypothyroidism. Intravenous triiodothyronine successfully stabilized the infant before anesthesia, marking a novel therapeutic approach.
Area of Science:
- Pediatric Endocrinology
- Interventional Radiology
- Anesthesiology
Background:
- Infantile hepatic hemangiomas are rare vascular tumors.
- Severe congenital hypothyroidism can cause myocardial depression, complicating anesthesia.
- Conventional thyroxine therapy was ineffective in this infant.
Observation:
- A critically ill infant presented with both a hepatic hemangioma and severe hypothyroidism.
- The infant exhibited myocardial depression due to hypothyroidism.
- The hepatic hemangioma required embolization.
Findings:
- This report describes the perioperative management of a complex pediatric case.
- Intravenous triiodothyronine was administered to stabilize the infant's hypothyroid state.
- Successful stabilization allowed for general anesthesia and subsequent embolization.
Implications:
- Intravenous triiodothyronine represents a potential therapeutic option for stabilizing hypothyroid infants before surgery.
- This case highlights the importance of managing severe hypothyroidism in critically ill infants.
- Effective perioperative management is crucial for infants with co-existing rare conditions like hepatic hemangiomas and hypothyroidism.
Abstract:
Hepatic haemangiomas in infants are rare. An infant with both a hepatic haemangioma and a severe hypothyroid condition, unresponsive to conventional thyroxine therapy, will be described. This case presented here is the perioperative management of a critically ill infant who had myocardial depression secondary to hypothyroidism and a hepatic haemangioma that required embolization. To our knowledge, this is the first published report describing intravenous triiodothyronine as a therapeutic modality to stabilize a hypothyroid infant prior to undergoing a general anaesthetic.