A 75-YEAR OLD PATIENTWITH MULTINODULAR GOITER COMPLICATED WITH MITRAL STENOSIS AND CHRONIC PULMONARY DISEASE – THE IMPORTANCE OF SURGEONPERFORMED ULTRASOUND
Abstract:
Introduction: We describe the management of a-75 year old patient with chronic obstructive
pulmonary disease (COPD), II New York Heart Association (NYHA) class heart failure, mitral stenosis
and hypertension who presented with mild respiratory distress and dysphagia secondary to compression
from a multinodular goiter. In order to properly manage this case, we reviewed the current State of the
Art on multinodular goiter in patients with multiple associated pathologies. Results: A multidisciplinary
team was assembled including anesthesiology, cardiology and otolaryngology specialists. The patient
underwent a cervicotomy with the removal of the compressive thyroid goiter. Conclusions: Airway
obstruction and swallowing problems from extra-tracheal compression in a patient with coexistent
morbidity represent a unique management dilemma. Therefore, we relied on surgeon-performed
ultrasound exam to ascertain all the risks and the possibility of surgical removal of the thyroid mass.
The ultrasound exam enabled the correct and complex surgical planning along with an improved
resident training concerning the procedure.
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