无法手术的副神经节瘤产妇紧急剖宫产的麻醉管理:一例具有挑战性的病例报告

Samahir AlJubairy, Sara Alwatban, Abdullah Alraffa
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引用次数: 0

摘要

副神经节瘤是一种神经内分泌肿瘤,其特征是由能产生儿茶酚胺的神经内分泌细胞组成的小器官。由于此类肿瘤的性质,血流动力学不稳定可能对治疗构成挑战。这种情况会影响不同临床环境下的医疗服务。本病例报告的目的是强调麻醉管理的分娩患者与腹盆腔副神经节瘤,特别是在紧急剖宫产。在妊娠34周时,33岁女性患者三次怀孕,两次分娩,已知无法手术的大盆腔和下腹部腹膜后副神经节瘤,放疗反应差。15.5 × 4.2 × 22 cm肿瘤包裹主动脉、下腔静脉和双侧髂血管,压迫腰椎。在多学科团队的努力下,患者顺利完成了剖宫产。副神经节瘤在产妇及其优化过程中很少报道。尽管被紧急剖宫产手术打断,但手术得到了安全有效的处理,母亲和胎儿都安全分娩,术后恢复无并发症。
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Anesthetic management of an emergency cesarean section in a parturient with inoperable paraganglioma: A challenging case report
Paraganglioma is a neuroendocrine tumor characterized by small organs comprising neuroendocrine cells that can produce catecholamines. Because of the nature of such tumors, hemodynamic instability can pose a management challenge. This condition can influence the provision of medical care across different clinical settings. The aim of this case report is to highlight anesthesia management in parturient patients with abdominopelvic paraganglioma, particularly during an emergency cesarean section. At 34 weeks of gestation, the 33-year-old female patient with three pregnancies and two past deliveries had a known case of inoperable large pelvic and lower abdominal retroperitoneal paraganglioma and poor radiotherapy response. The 15.5 × 4.2 × 22 cm tumor encased the aorta, inferior vena cava, and bilateral iliac vessels, compressing the lumbar vertebrae. The patient had an uneventful and successful cesarean delivery with a multidisciplinary team effort. Paragangliomas are rarely reported in a parturient and its optimization course. Despite being interrupted by an emergency cesarean section, which was handled safely and effectively, both mother and fetus had a safe delivery and postoperative recovery without complications.
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审稿时长
29 weeks
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