Testini Mario, Gurrado Angela, Lissidini Germana, Lardo Domenica, Poli Elisabetta, Piccinni Giuseppe
Section of General and Thoracic Surgery, Department of Applications in Surgery of Innovative Technologies, University Medical School of Bari, Bari, Italy.
Int Surg. 2008 May-Jun;93(3):158-62.
A 42-year-old woman was evaluated for an emergency at our surgical department for acute dyspnea associated with a spontaneous and rapidly enlarging mass of the neck. Clinical examination revealed a large, firm, nonfluctuant thyroid swelling on the right side of the neck. An urgent computerized tomography scan showed a hematoma within the right lobe of the thyroid and tracheal deviation with marked luminal narrowing. Because of the rapid progression of respiratory distress, endotracheal intubation by flexible laryngoscopy revealing normal vocal cords function and emergency total thyroidectomy were performed. During the operation, the thyroid gland showed a huge, edematous, nonfluctuant, rubbery, firm swelling with easy bleeding on touch, but the capsule appeared to be intact without rupture. Microscopic examination revealed a colloid multinodular goiter with massive parenchymal hemorrhage. Recovery was uneventful, and the patient was discharged 2 days after the operation.
一名42岁女性因颈部突发迅速增大的肿块伴急性呼吸困难，在我院外科接受急诊评估。临床检查发现右侧颈部有一个大的、质地硬、无波动感的甲状腺肿大。紧急计算机断层扫描显示甲状腺右叶内有血肿，气管偏移，管腔明显狭窄。由于呼吸窘迫迅速进展，遂通过可弯曲喉镜进行气管插管，显示声带功能正常，并进行了急诊全甲状腺切除术。手术中，甲状腺呈现巨大、水肿、无波动感、似橡胶样的硬肿，触之易出血，但包膜似乎完整未破裂。显微镜检查显示为伴有大量实质内出血的胶样结节性甲状腺肿。恢复过程顺利，患者术后2天出院。
