A & A case reports
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Acquired tracheoesophageal fistula is a rare and devastating complication of lung cancer. The diagnosis is typically confirmed on barium esophagram. We report a case of a patient with lung cancer status after palliative chemoradiotherapy and esophageal stenting for malignant stenosis who presented with signs and symptoms suggestive of tracheoesophageal fistula; however, no evidence of fistula was found on barium esophagram. During subsequent esophagogastroduodenoscopy, the presence of a fistula was verified by capnography, given extreme elevations in end-tidal CO2 concentrations during endoscopic CO2 insufflation.
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Case Reports
Successful Continuous Adductor Canal Block Placement in a Patient With Absent Sartorius Muscle: A Case Report.
We report a novel case of a patient who presented for elective total knee arthroplasty and had distorted adductor canal anatomy due to previous sartorius rotational flap surgery. Despite the lack of a sartorius muscle on the intended operative limb, we describe the successful placement of a continuous adductor canal block. This case is a clinically relevant example that highlights the importance of the vastoadductor membrane as the anatomical anteromedial boundary for the adductor canal, and that it remains intact even after sartorius muscle flap surgery.
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Case Reports
Chest Pain During Cesarean Delivery in Relation to Anomalous Right Coronary Artery: A Case Report.
Chest pain during labor can have many etiologies, one of which is myocardial ischemia. We report a 38-year-old woman with American Society of Anesthesiology physical status I scheduled for elective cesarean delivery who experienced chest pain and electrocardiographic signs of myocardial ischemia immediately after carbetocin administration. ⋯ This was considered the likely cause of the patient's chest pain. The patient gave written permission for the authors to publish this report.
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In a patient undergoing thoracoscopic esophagectomy and concomitant wedge resection, an iatrogenic lesion in the left main bronchus was observed following deflation of the right lung. Because the bronchial cuff of the double-lumen tube was visible through the lesion, repair was only possible after deflation of the bulging cuff. ⋯ This challenging situation was resolved using the Ventrain device to oxygenate the patient through a small-bore catheter placed through the lumen beyond the bronchial defect. With the use of this technique, oxygenation was maintained at an acceptable level during repair.
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Case Reports
Intraoperative Hyperkalemia and Ventricular Arrhythmia During Parathyroidectomy: A Case Report.
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.