Carreira Germano, Pascoal Mariana, Ferreira Celine
Anesthesiology, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Cureus. 2024 Nov 14;16(11):e73709. doi: 10.7759/cureus.73709. eCollection 2024 Nov.
Hiatal hernias are common in the elderly and in most cases asymptomatic and no intervention is needed. Hiatal hernias can range from asymptomatic to an intrathoracic stomach, a rare but potentially life-threatening condition, characterized by the migration of the stomach into the thoracic cavity. Its need for urgent intervention presents a major concern for the anesthesiologist because it is associated with a high risk of aspiration. This case report discusses the clinical presentation and anesthetic management of an intrathoracic full stomach proposed for urgent surgery. By presenting this case, we hope to enhance the understanding of preoperative management in patients with intrathoracic full stomach and the role of awake fiberoptic guided intubation as a valuable technique in emergency surgical settings. This case reinforces the importance of existing healthcare professionals with practice in managing similar clinical scenarios effectively.
食管裂孔疝在老年人中很常见,大多数情况下无症状,无需干预。食管裂孔疝的表现从无症状到胃位于胸腔内,这是一种罕见但可能危及生命的情况,其特征是胃移入胸腔。由于它与误吸的高风险相关,因此需要紧急干预成为麻醉医生主要关注的问题。本病例报告讨论了拟行紧急手术的胸腔内全胃患者的临床表现及麻醉管理。通过展示此病例,我们希望增进对胸腔内全胃患者术前管理的理解,以及清醒纤维支气管镜引导插管作为急诊手术环境中一项有价值技术的作用。该病例强化了现有医疗专业人员在有效管理类似临床情况方面实践的重要性。