Post- Thyroidectomy Haematoma
Causing Severe Supraglottic Oedema and
Pulmonary Oedema - A Case Report
Published: August 1, 2014 | DOI: https://doi.org/10.7860/JCDR/2014/.4745
Leena Harshad Parate, Vinayak Seenappa Pujari, Tejesh C Anandaswamy, Saurabh Vig
1. Assistant Professor, Department of Anaesthesia, M.S. Ramaiah Medical College, Bangalore, Karnataka, India.
2. Associate Professor, Department of Anaesthesia, M.S. Ramaiah Medical College, Bangalore, Karnataka, India.
3. Assosciate Professor, Department of Anaesthesia, M.S. Ramaiah Medical College, Bangalore, Karnataka, India.
4. Junior Resident, Department of Anaesthesia, M.S. Ramaiah Medical College, Bangalore, Karnataka, India.
Correspondence
Dr. Leena Harshad Parate,
Assistant Professor, Department of Anaesthesia, M.S. Ramaiah Medical College, Bangalore. Karnataka, India.
Phone : +9480525925, E-mail : dr_leenag@yahoo.co.in
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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