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[Case of caesarian section in a patient with a giant mediastinal tumor]
Masakazu Yamaoka1, Kazumi Ido, Hiroshi Naitou
1Department of Anesthesia, Intensive Care Unit, Hiroshima City General Hospital, Hiroshima 730-0011.
Administering anesthesia to a patient with a mediastinal tumor may lead to respiratory difficulty with relatively high morbidity and mortality. A 35-year-old pregnant woman with a large mediastinal tumor was scheduled for caesarian section. Chest roentgenography revealed a large mediastinal tumor. General anesthesia was selected to cope with possible worsening of dyspnea and coughing which could be more likely to occur during spinal anesthesia. Mechanical ventilation caused no trouble. When she started spontaneous breathing after the operation, dyspnea suddenly developed and SpO2 began to fall. Emergency bronchofiberscopy revealed almost total occlusion of the right main bronchus due to extrinsic compression.
Administering anesthesia to a patient with a mediastinal tumor may lead to respiratory difficulty with relatively high morbidity and mortality. A 35-year-old pregnant woman with a large mediastinal tumor was scheduled for caesarian section. Chest roentgenography revealed a large mediastinal tumor. General anesthesia was selected to cope with possible worsening of dyspnea and coughing which could be more likely to occur during spinal anesthesia. Mechanical ventilation caused no trouble. When she started spontaneous breathing after the operation, dyspnea suddenly developed and SpO2 began to fall. Emergency bronchofiberscopy revealed almost total occlusion of the right main bronchus due to extrinsic compression.