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Int J Surg Case Rep. 2014;5(12):1251-3. doi: 10.1016/j.ijscr.2014.11.012. Epub 2014 Nov 11.

Emergency thyroidectomy: Due to acute respiratory failure.

International journal of surgery case reports

Zulfu Bayhan, Sezgin Zeren, Bercis Imge Ucar, Isa Ozbay, Yalcin Sonmez, Metin Mestan, Onur Balaban, Nilufer Araz Bayhan, Mehmet Fatih Ekici

Affiliations

  1. Department of General Surgery, Faculty of Medicine, Dumlupinar University, 43020 Kutahya, Turkey. Electronic address: [email protected].
  2. Department of General Surgery, Faculty of Medicine, Dumlupinar University, 43020 Kutahya, Turkey. Electronic address: [email protected].
  3. Department of General Surgery, Faculty of Medicine, Dumlupinar University, 43020 Kutahya, Turkey. Electronic address: [email protected].
  4. Department of Otolaryngology, Faculty of Medicine, Dumlupinar University, 43020 Kutahya, Turkey. Electronic address: [email protected].
  5. Department of General Surgery, Dumlupinar University Evliya Celebi Education and Research Hospital, 43020 Kutahya, Turkey. Electronic address: [email protected].
  6. Department of General Surgery, Dumlupinar University Evliya Celebi Education and Research Hospital, 43020 Kutahya, Turkey. Electronic address: [email protected].
  7. Department of Anesthesiology and Reanimation, Faculty of Medicine, Dumlupinar University, 43020 Kutahya, Turkey. Electronic address: [email protected].
  8. Department of Anesthesiology and Reanimation, Dumlupinar University Evliya Celebi Education and Research Hospital, 43020 Kutahya, Turkey. Electronic address: [email protected].
  9. Department of General Surgery, Dumlupinar University Evliya Celebi Education and Research Hospital, 43020 Kutahya, Turkey. Electronic address: [email protected].

PMID: 25437688 PMCID: PMC4276272 DOI: 10.1016/j.ijscr.2014.11.012

Abstract

INTRODUCTION: Giant cervical and mediastinal goiter may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Here, we present a case admitted to the emergency service with a giant goiter along with respiratory failure and poor general health status, which required urgent surgical intervention.

PRESENTATION OF CASE: A 71-year-old female admitted to the emergency room with shortness of breath and poor general health status resulting from a giant cervical swelling progressively increased during the last 7 years and constituted severe respiratory failure which has become severe in the last one month. A giant nodular goiter of the left thyroid lobe extending retrosternally, causing tracheal compression, limiting the neck movements was detected with clinical examination and bedside ultrasound. Emergency thyroidectomy was planned. Fiberoptic-assisted awake nasal intubation was performed in the operating room. Emergency total thyroidectomy was performed for the life-threatening respiratory failure. Postoperative period was uneventful. She was transferred from intensive care unit to the ward on postoperative day 3 and was discharged from the hospital on the postoperative 7th day. Benign multinodular hyperplasia was reported on the histopathological report. Patient was included in routine follow-up.

DISCUSSION: In the present case tracheal destruction due to compression of the giant goiter was found in agreement with previous reports. Emergency thyroidectomy was performed after awake intubation since it is a common surgical option for the treatment of giant goiter causing severe airway obstruction.

CONCLUSION: Respiratory failure due to giant nodular goiter is a life-threatening situation and should be treated immediately by performing awake endotracheal intubation following emergency total thyroidectomy.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Awake intubation; Giant goiter; Laryngotracheal compression; Respiratory failure; Retrosternal; Thyroidectomy

References

  1. Asian J Surg. 2009 Apr;32(2):81-4 - PubMed
  2. Br J Hosp Med (Lond). 2011 Mar;72(3):M44-7 - PubMed
  3. Arq Bras Endocrinol Metabol. 2011 Apr;55(3):229-32 - PubMed
  4. Int J Med Sci. 2012;9(9):778-85 - PubMed
  5. Tex Heart Inst J. 2005;32(2):224-7 - PubMed
  6. J Natl Med Assoc. 2006 Jan;98(1):86-9 - PubMed
  7. World J Emerg Surg. 2012 Apr 11;7:9 - PubMed
  8. Endokrynol Pol. 2013;64(3):215-9 - PubMed
  9. World J Surg. 2008 Jul;32(7):1285-300 - PubMed

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