A & A case reports
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Tracheal stenosis in pregnancy is a relatively rare occurrence and there are limited data regarding the perioperative management of these patients. Various surgical treatment options are available to include open repair, long-term tracheostomy, or endoscopic repair (rigid versus balloon dilation). We report the case of a woman in her third trimester of pregnancy, with known recurrent and worsening history of subglottic tracheal stenosis, who underwent awake microlaryngoscopy with potassium titanyl phosphate laser radial incision and serial tracheal balloon dilation under topical anesthesia with sedation. We further discuss her perioperative multidisciplinary management.
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We describe a case of a thoracic epidural abscess after epidural catheter insertion in a patient undergoing lobar segmentectomy. The patient described a "pulsatile" back pain the sixth day after surgery, and purulent material at the entry site of the catheter was observed. The image of the nuclear magnetic resonance confirmed an epidural abscess that was treated conservatively with antibiotics after a consensus decision among neurosurgery, infectious diseases an anesthesia services. The abscess was reabsorbed completely with no sequelae.
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We report a case of a patient undergoing esophagectomy for end-stage achalasia, a rare condition associated with potentially catastrophic ventilatory and circulatory complications. The complexity of the case necessitated preoperative planning with the surgical specialist, development of a novel algorithm for airway management, and careful implementation of our plan. Isolation of the lungs from the esophagus presented unique challenges due to not only the anatomic derangements that are the hallmark of this disease process but also an unusual anatomic finding seen in this patient.
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In the United States, more than 100,000 tracheostomies are performed annually. Many patients undergoing tracheostomy are critically ill, making them higher risk surgical candidates. ⋯ In this report, we describe a technique to minimize the risk of airway loss by using an airway exchange catheter as an airway conduit during endotracheal tube removal. We present 2 clinical cases in which this technique was used successfully and made an important contribution to patient safety.