scholarly journals Urgent surgery for COVID-19–positive pediatric patient

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Franchesca Rivera-Calonje ◽  
Shiu-Yi Emily Chen ◽  
Carl Lo ◽  
Sang Le ◽  
Makoto Nagoshi
Keyword(s):  
Spinal Anesthesia ◽  
Pediatric Patient ◽  
Healthcare Providers ◽  
Safe Alternative ◽  
Incision And Drainage ◽  
Case Presentation ◽  
Urgent Surgery ◽  
Intervention Patient ◽  
Lateral Decubitus ◽  
Endotracheal Anesthesia

Abstract Background We present a case of COVID-19–positive pediatric patient for urgent urological surgery by spinal anesthesia to avoid aerosolizing procedure. Case presentation A 12-year-old, COVID-19–positive boy presented for urgent wound incision and drainage at the circumcision site. Our anesthetic plan consisted of spinal anesthesia with sedation. He was transported from the COVID-19 isolation floor to the negative pressure operating room. He was placed in lateral decubitus position and oxygen was delivered through facemask. Under sedation, spinal anesthesia was achieved at first attempt. The patient maintained spontaneous ventilation without airway intervention. Patient was recovered in the operation room then transported back to the floor. Conclusion Spinal anesthesia is a safe alternative to general endotracheal anesthesia for many pediatric urology procedures. Effective team communication and preparation are keys when caring COVID-19–positive patient in perioperative setting to avoid minimize the risk to healthcare providers.

Endotracheal intubation with video laryngoscope at semilateral decubitus position: a case report of a pediatric patient with a back stab wound

2020 ◽  
Keyword(s):  
Endotracheal Intubation ◽  
Pediatric Patient ◽  
Supine Position ◽  
Pediatric Patients ◽  
Stab Wound ◽  
Vital Signs ◽  
Video Laryngoscope ◽  
Case Presentation ◽  
Emergent Operation ◽  
Endotracheal Anesthesia

Background: Endotracheal intubation is routinely performed in a supine position. However, this position might be difficult for some emergent patients. Although several alternative positions have been suggested for adult patients, such studies on pediatric patients are rare. Case presentation: We present a case of a female pediatric patient with a pencil stab wound to the back requiring an emergent operation under general endotracheal anesthesia. Placing her in supine position would have been inappropriate because of the protruding pencil. The patient was moved to a semilateral decubitus position for intubation. The endotracheal tube was inserted with a video laryngoscope. Her vital signs and oxygen saturation were stable during operation. The patient was discharged without complications. Conclusion: Semilateral intubation in pediatric patients using a video laryngoscope may be feasible under some specific conditions that make it inappropriate to place patients in a supine position.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

scholarly journals An alternative approach for complicated prosthetic aortic valve endocarditis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Dimos Karangelis ◽  
Argyris Krommydas ◽  
Fotios A. Mitropoulos
Keyword(s):  
Surgical Treatment ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Pericardial Patch ◽  
Safe Alternative ◽  
Case Presentation ◽  
Prosthetic Aortic Valve ◽  
Alternative Approach ◽  
Sutureless Valve ◽  
Valve Implantation

Abstract Background Surgical treatment of prosthetic valve endocarditis (PVE) with destruction of the aortic root and aortomitral continuity is demanding even in experienced hands. Case presentation Herein, we describe a case of a 71-year-old female patient who presented with PVE that was further complicated by a fistulous abscess cavity. The patient underwent removal of the dehisced prosthetic valve, radical annular debridement, reconstruction of the aortomitral curtain with a pericardial patch as a patch exclusion technique and implantation of a sutureless valve. Conclusion Patch exclusion technique, followed by sutureless valve implantation, might represent a feasible and safe alternative for the surgical treatment of complicated PVE.

Case presentation of soft tissue parapharyngeal chondroma in a pediatric patient

2013 ◽  
Vol 34 (6) ◽  
pp. 720-723 ◽  
Author(s):  
Erin J. Smith ◽  
Luminita Rezeanu ◽  
Jeffrey Carron
Keyword(s):  
Soft Tissue ◽  
Pediatric Patient ◽  
Case Presentation

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

scholarly journals Lobar torsion after thoracoscopic esophagectomy, and prevention method to detect its incidence during the operation

2016 ◽  
Author(s):  
Yutaka Miyawaki ◽  
Yasuaki Nakajima ◽  
Yutaka Tokairin ◽  
Kenro Kawada ◽  
Taichi Ogo ◽  
...  
Keyword(s):  
Pulmonary Resection ◽  
Middle Lobe ◽  
Thoracoscopic Esophagectomy ◽  
Fatal Complication ◽  
Case Presentation ◽  
Urgent Surgery ◽  
Right Middle Lobe ◽  
Prevention Method ◽  
Pulmonary Torsion ◽  
The Right

Abstract Introduction: Lobar torsion is a rare but fatal complication, with such cases being mostly treated with pulmonary resection. Only a few cases of pulmonary torsion following esophagectomy have thus far been reported, and all cases occurred subsequent to transthoracic esophagectomy. Case presentation: We herein present the case of a patient with the right middle lobe torsion after thoracoscopic esophagectomy in a 64-year-old male.As the patient exhibited a hemodynamically unstable condition immediately after surgery and bronchoscopy and computed tomography revealed right middle lobe torsion, urgent surgery was performed.As torsion of right middle lobe was confirmed during a second operation, repositioning for torsion was performed. Fortunately, right middle lobe was aerated and exhibited a good complexion immediately after repositioning; therefore, pneumonectomy was not performed. Conclusion: Because it is difficult to observe the process of reinflation of a collapsed lung under direct vision in order to prevent lobar torsion when performing thoracoscopic esophagectomy, it is imperative to confirm the patency of the proximal bronchi during the operation using bronchoscopy.

Case presentation and images of a lingual osseous choristoma in a pediatric patient

2015 ◽  
Vol 36 (6) ◽  
pp. 753-754 ◽  
Author(s):  
James K. Stanford ◽  
James C. Spencer ◽  
J. Mark Reed
Keyword(s):  
Pediatric Patient ◽  
Case Presentation

Stereotactic suboccipital transcerebellar biopsy under local anesthesia using the Cosman-Roberts-Wells frame

1991 ◽  
Vol 75 (3) ◽  
pp. 486-488 ◽  
Author(s):  
Roberto Spiegelmann ◽  
William A. Friedman
Keyword(s):  
Local Anesthesia ◽  
Stereotactic Biopsy ◽  
Operative Procedure ◽  
Content Type ◽  
Routine Biopsy ◽  
Lateral Decubitus ◽  
Biopsy Methods ◽  
Time Required ◽  
Endotracheal Anesthesia ◽  
Selection Of

✓ Previously reported suboccipital transcerebellar stereotactic biopsy methods, performed with the patient in the prone position, have required general endotracheal anesthesia. A technique is described for performing such biopsies with the patient in the lateral decubitus position, under local anesthesia. Phantom planning and routine computerized tomography graphics allow the selection of a safe entry point and intra-axial trajectory to the lesion. The time required for data acquisition and the operative procedure itself compares well with that of more routine biopsy techniques.

The Influence of Spinal Flexion in the Lateral Decubitus Position on the Unilaterality of Spinal Anesthesia

2013 ◽  
Vol 117 (4) ◽  
pp. 1017-1021 ◽  
Author(s):  
Jin-Tae Kim ◽  
Jong-Hwan Lee ◽  
Chan-Woo Cho ◽  
Hyo-Cheol Kim ◽  
Jae-Hyon Bahk
Keyword(s):  
Spinal Anesthesia ◽  
Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
Spinal Flexion
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