Post- Thyroidectomy Haematoma Causing Severe Supraglottic Oedema and Pulmonary Oedema - A Case Report

Autor: Leena Harshad Parate, Vinayak Seenappa Pujari, Tejesh C Anandaswamy, Saurabh Vig
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Journal of Clinical and Diagnostic Research, Vol 8, Iss 8, Pp GD01-GD02 (2014)
Druh dokumentu: article
ISSN: 2249-782X
0973-709X
DOI: 10.7860/JCDR/2014/9012.4745
Popis: Large, long standing goiters present multiple challenges to anaesthesiologist. Post thyroidectomy haematoma is a rare but life threatening complication of thyroid surgery leading to airway obstruction. We report a case of huge goiter that underwent near total thyroidectomy and developed post thyroidectomy haematoma. Within no time it resulted in near fatal airway obstruction, pulmonary oedema and cardiac arrest. The haematoma was evacuated immediately and patient was resuscitated successfully. Pulmonary oedema was further worsened by subsequent aggressive fluid resuscitation. She was electively ventilated with PEEP and was extubated after five days. Except for right vocal cord palsy her postoperative stay was uneventful. This is unique case where a post thyoidectomy haematoma has resulted in fatal supraglottic oedema and pulmonary oedema. Early recognition, immediate intubation and evacuation of haematoma are the key to manage this complication. We highlight on the pathophysiology of haematoma and discuss the strategies to prevent similar events in future.
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