Lin C M, Hsu J C
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taipei, Taiwan, ROC.
Can J Anaesth. 2001 Jan;48(1):78-80. doi: 10.1007/BF03019819.
To report a child with anterior mediastinal tumour misdiagnosed as pericardial effusion who had been sent to the operating theatre for drainage. After induction of general anesthesia she developed cardio-respiratory collapse. The diagnosis was made with the aid of transesophageal echocardiography (TEE).
A 14-yr-old girl suffered from cough and intermittent fever for one month before admission. Four days before admission, she became orthopneic and was admitted to the intensive care unit. Precordial echocardiography showed an anterior and posterior echolucent space between the pericardium and epicardium that was thought to be a pericardial effusion. She was sent to the operating room for emergency drainage. After induction of general anesthesia, breath sounds were not heard on the left side of the chest. The patient developed increasing hypoxemia and hypotension despite cardiocentesis. A TEE determined that an anterior mediastinal mass was the cause of her hypoxemia and hypotension. The tumour was debulked and the patient made an uneventful postoperative recovery.
In this case, the correct diagnosis of an anterior mediastinal mass was made with TEE. The place of TEE may be indicated in patients with unexplained hypoxemia and hypotension.
报告一名前纵隔肿瘤被误诊为心包积液的儿童，该患儿被送往手术室进行引流。全身麻醉诱导后，她出现心肺功能衰竭。借助经食管超声心动图（TEE）做出了诊断。
一名14岁女孩入院前咳嗽、间断发热1个月。入院前4天，她出现端坐呼吸，被收入重症监护病房。心前区超声心动图显示心包和心外膜之间有前后无回声区，被认为是心包积液。她被送往手术室进行紧急引流。全身麻醉诱导后，左侧胸部未闻及呼吸音。尽管进行了心脏穿刺，患者的低氧血症和低血压仍不断加重。TEE确定前纵隔肿块是其低氧血症和低血压的原因。切除了肿瘤，患者术后恢复顺利。
在本病例中，通过TEE正确诊断了前纵隔肿块。对于原因不明的低氧血症和低血压患者，可能需要进行TEE检查。
