1/5. Anaesthetic considerations in bronchial adenoma.The patient with bronchial adenoma can present a puzzling diagnostic dilemma as well as challenging problems in anaesthetic management. Several aspects are reviewed in this report. Diagnostically these include chest roentgenographic findings and unique pulmonary function test. Problems in anaesthetic management include possible development of acute carcinoid syndrome, as this tumour is usually of the carcinoid variety. In addition, the tumour may act as a ball valve, causing uneven ventilation of affected lung with expiratory air trapping. Several factors may necessitate prolonged bronchial blockage during anaesthesia. These include a friable mass which may bleed profusely upon manipulation, infected and atelectatic parenchymal tissue beyond the obstruction, copious volumes of purulent secretions, and one lung ventilation during resection.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. The role of endobronchial electrocautery in the management of malignant airway obstruction.bronchoscopy has evolved well beyond a simple look-see examination, with new interventional techniques becoming more commonly employed. So-called interventional bronchoscopy implies the use of bronchoscopy as a therapeutic, in addition to diagnostic, tool. We present 2 cases to illustrate the utility of one such interventional technique, tumour ablation by endobronchial electrocautery and snaring, in the management of airway obstruction by tumour. This procedure, performed via a flexible bronchoscope under local anaesthesia can spare patients time-consuming, expensive treatments with their attendant morbidity, and in some cases can be life-saving. There is minimal morbidity associated with this technique. It is anticipated that interventional bronchoscopy will continue to revolutionise management of such conditions in the future, and become a necessary facility in all pulmonary medicine units.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/5. Bronchial adenoma mimicking complication of endotracheal intubation.A 39-year-old Chinese lady was admitted to hospital for an emergency caesarian section under general anaesthesia. After intubation it was discovered that there was diminished air entry to the left side. The cause could not be elicited during anaesthesia and a postoperative chest radiograph revealed no abnormality. Subsequent tomography revealed a mass in the lumen of the left main bronchus. biopsy of the lesion revealed an adenoid cystic carcinoma (bronchial adenoma-cylindroma type). By causing airway obstruction with gas trapping this rare neoplasm may present as the cause of a problem mimicking more common complications of endotracheal intubation.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
4/5. Anaesthetic complications of mediastinal masses and superior vena caval obstruction.Two patients with mediastinal tumour and superior vena caval obstruction who, after general anaesthesia, experienced respiratory difficulties requiring intubation or reintubation are presented. Possible aetiological mechanisms are discussed in relation to these cases.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/5. Resection of distal tracheal and carinal tumours with the aid of cardiopulmonary bypass.Two cases of carinal and tracheal reconstruction with the aid of cardiopulmonary bypass (CPB) are presented. The technical problems of surgery and anaesthesia which necessitated CPB in these two patients are discussed. CPB provides both adequate oxygenation and an unobstructed surgical field with optimal access to the trachea and carina. It permits atraumatic handling of the airways and reduction of anastomotic tension during the repair.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |