Acute airway obstruction due to benign multinodular goitre

Dias, Teresa; Santos, Arsénio; Mesquita, Carlos; Santos, Rui M

doi:10.1136/bcr-2018-228095

Cited by 4 publications

(3 citation statements)

References 13 publications

(10 reference statements)

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“…However, the pathophysiology of acute airway obstruction in a patient with goitre may involve multiple mechanisms including acute bleeding, tracheal mucosal oedema and secretion retention 7. This may be secondary to direct tracheal compression from the goitre or as a result of intercurrent acute viral upper respiratory tract viral infection that leads to decompensation in an already obstructed airway.…”

Section: Discussionmentioning

confidence: 99%

Benign multinodular goitre presenting as acute decompensated type two respiratory failure

Khalil,

Liyanage,

Ishaq

et al. 2024

BMJ Case Rep

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Acute airway obstruction is a life-threatening complication of benign goitre mostly occurring in cases of known progressing goitres. The index presentation of goitre with decompensated type two respiratory failure is an exceedingly rare and a diagnostically challenging presentation. We discuss the case of a woman in her 50 s, who had been diagnosed with asthma by her general practitioner, but during admission was found to have a large goitre with retrosternal extension causing critical tracheal compression. She presented with acute decompensated type two respiratory failure. We explore the diagnostic confounding posed by the patient’s background of asthma and describe the initial management of the patient with non-invasive ventilation by the emergency department. The diagnosis of upper airway obstruction was not apparent which is an interesting anomaly in this case. She underwent an emergency hemithyroidectomy and recovered with a resolution of her respiratory symptoms. Histology confirmed benign multinodular hyperplasia.

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Section: Discussionmentioning

confidence: 99%

Benign multinodular goitre presenting as acute decompensated type two respiratory failure

Khalil,

Liyanage,

Ishaq

et al. 2024

BMJ Case Rep

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“…Acute dyspnea due to airway obstruction without local signs of thyroid enlargement in previously undiagnosed goiters remains a rarity (6). Such a clinical presenta-tion is rare, occurring in only up to 0.6% of cases (7). Therefore, this initial manifestation of thyroid dysfunction in the postoperative course may lead to a false diagnosis and potentially a lethal event (8).…”

Section: Discussionmentioning

confidence: 99%

Acute dyspnea following knee joint total endoprosthesis – a diagnostic surprise

Miletic,

Röschel,

Jovanovic

et al. 2023

FEM

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Acute dyspnea, sometimes dramatic, is most often caused by cardiovascular or respiratory disease. However, although rare, thyroid dysfunction may present a similar clinical picture with equally serious and life-threatening consequences. Therefore, every occurrence of acute dyspnea represents a special medical challenge in diagnosis and treatment. We present a case of 81-year-old male admitted to the rehabilitation department five days after a knee joint total endoprosthesis and developed acute dyspnea two days later. An emergency diagnostic was performed and confirmed an airway stenosis through a previously undiagnosed enlarged thyroid gland. Although in most cases an acute life-threatening postoperative dyspnea indicates a cardiac or pulmonary problem, other diseases must be taken into consideration.

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“…Mechanisms of dyspnea are believed to be direct extrinsic tracheal compression, dysfunction of the recurrent laryngeal nerve, and lung atelectasis 24 . Instead, in less than 5 % of cases the clinical presentation of RG may be acute: spontaneous hemorrhagic enlargement of RG may occur during pregnancy 25,26 or for unclear reasons 27,28 , acute asphyxia and cardiac arrest have been described 29,30 , and some authors have hypothesized a direct phrenic nerve compression by the RG as the main cause of these dramatic scenarios 31 .…”

Section: Clinical Presentationmentioning

confidence: 99%

A critical update on the management of retrosternal goiter

Miani,

Locatello,

Bergamin-Bracale

et al. 2023

Preprint

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Background: Retrosternal goiters (RGs) pose several challenges to head and neck surgeons because of the intricate anatomical relationships with major vessels and other mediastinal structures. Methods: A scoping review of the last five years in the PubMed database was conducted and a total of 105 articles were discussed, along with methodological issues and future directions in the research on RGs. Results: The surgical excision of RGs may be accomplished by standard transcervical approach in the vast majority of cases, yet the potential need for a transthoracic approach must be always kept in mind. Great expertise in referral centers is required to maintain an acceptable rate of postoperative complications, and a thorough diagnostic work-up is mandatory. Several non-surgical treatments in addition to mini-invasive approaches have been proposed for RGs. Conclusions: RGs require a multidisciplinary thyroid team in order to eventually minimize the risk of complications and avoid extracervical approaches.

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Acute airway obstruction due to benign multinodular goitre

Cited by 4 publications

References 13 publications

Benign multinodular goitre presenting as acute decompensated type two respiratory failure

Benign multinodular goitre presenting as acute decompensated type two respiratory failure

Acute dyspnea following knee joint total endoprosthesis – a diagnostic surprise

A critical update on the management of retrosternal goiter

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