Surgical and Radiological Management of Complicated Uterine Leiomyoma Aided by 3D Models in a Patient with Fibrodysplasia Ossificans Progressiva

被引：1

作者：

Ho, Michelle ^{[1
,2
]}

Park, Beau Y. ^{[3
]}

Rosenblum, Norman G. ^{[3
]}

Al Mukaddam, Mona ^{[4
,5
]}

Kaplan, Frederick S. ^{[4
,5
]}

Kucherov, Victor ^{[6
]}

Hubosky, Scott G. ^{[6
]}

Kane, Gregory ^{[7
]}

Desai, Vishal ^{[8
]}

Kramer, Michael R. ^{[8
]}

Ku, Bon S. ^{[2
,9
]}

Schwenk, Eric S. ^{[10
]}

Baratta, Jaime L. ^{[10
]}

Harshavardhana, Deepti ^{[10
]}

Grunwald, Zvi ^{[10
]}

机构：

[1] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA 19107 USA

[2] Thomas Jefferson Univ, Hlth Design Lab, Philadelphia, PA 19107 USA

[3] Thomas Jefferson Univ, Dept Obstet & Gynecol, Philadelphia, PA USA

[4] Univ Penn, Dept Med, Ctr Res FOP & Related Disorders, Perelman Sch Med, Philadelphia, PA 19104 USA

[5] Univ Penn, Dept Orthoped Surg, Ctr Res FOP & Related Disorders, Perelman Sch Med, Philadelphia, PA 19104 USA

[6] Thomas Jefferson Univ, Dept Urol, Philadelphia, PA 19107 USA

[7] Thomas Jefferson Univ, Dept Med, Philadelphia, PA 19107 USA

[8] Thomas Jefferson Univ, Dept Radiol, Philadelphia, PA 19107 USA

[9] Thomas Jefferson Univ, Dept Emergency Med, Philadelphia, PA 19107 USA

[10] Thomas Jefferson Univ, Dept Anesthesiol, Sidney Kimmel Med Coll, Philadelphia, PA 19107 USA

来源：

AMERICAN JOURNAL OF CASE REPORTS | 2021年 / 22卷

关键词：

Airway Management; Hysterectomy; Imaging; Three-Dimensional; Myositis Ossificans; ANESTHETIC MANAGEMENT; GENERAL-ANESTHESIA; BLOCK;

D O I：

10.12659/AJCR.931614

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: Rare disease Background: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disorder of the connective tissue. Over time, patients with FOP experience decreased range of motion in the joints and the formation of a second skeleton, limiting mobility. Patients with FOP are advised to avoid any unwarranted surgery owing to the risk of a heterotopic ossification flare-up. For patients who do require a surgical procedure, a multidisciplinary team is recommended for comprehensive management of the patient's needs. Case Report: A 27-year-old woman with FOP underwent a hysterectomy for removal of a suspected necrotic uterine fibroid. To aid in presurgical planning and management, patient-specific 3-dimensional (3D) models of the patient's tracheobronchial tree, thorax, and lumbosacral spine were printed from the patient's preoperative computed tomography (CT) imaging. The patient required awake nasal fiberoptic intubation for general anesthesia and transversus abdominus plane block for regional anesthesia. Other anesthesia modalities, including spinal epidural, were ruled out after visualizing the patient's anatomy using the 3D model. Postoperatively, the patient was started on a multi-modal analgesic regimen and a course of steroids, and early ambulation was encouraged. Conclusions: Patients with FOP are high-risk surgical patients requiring the care of multiple specialties. Advanced visualization methods, including 3D printing, can be used to better understand their anatomy and locations of heterotopic bone ossification that can affect patient positioning. Our patient successfully underwent supracervical hysterectomy and bilateral salpingectomy with no signs of fever or sepsis at follow-up.

引用

页数：9