Document Detail

Mechanical obstruction to ventilation from an ovarian cyst during pregnancy.
MedLine Citation:
PMID:  2065417     Owner:  NLM     Status:  MEDLINE    
This report documents the danger of the gravid uterus fixing a large ovarian cyst in a position disadvantageous to diaphragmatic excursion and thereby obstructing ventilation. A 34-year-old pregnant patient presented at 18 weeks amenorrhoea with a large ovarian cyst. She gave a history of exertional dyspnoea and orthopnoea. Clinical examination revealed a grossly enlarged abdomen and a respiratory rate of 28 breaths.min-1. Intraoperatively, ventilation was markedly impaired resulting in cyanosis and bradycardia. This was relieved by drainage of the ovarian cyst. A left lateral tilt with manual traction on the tumour may have avoided this problem. Should the above measures be inadequate, immediate drainage of the cyst is essential. Severe respiratory distress may require ultrasound-guided, percutaneous, aspiration of the cyst preoperatively. However, as in this patient, the absence of gross signs of respiratory failure does not preclude acute ventilatory failure after induction of anaesthesia.
D T Beng; L T Choon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  38     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-08-15     Completed Date:  1991-08-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  496-8     Citation Subset:  IM    
Department of Anaesthesia, Alexandria Hospital, Singapore.
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MeSH Terms
Airway Resistance
Anesthesia, Inhalation
Anesthesia, Intravenous
Ovarian Cysts / complications*,  pathology
Pregnancy Complications*
Respiratory Insufficiency / etiology*,  physiopathology
Respiratory Mechanics

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