Anesthetic considerations in Demons-Meigs' syndrome: A case report

被引：2

作者：

Fjouji S. ^{[1
]}

Bensghir M. ^{[1
]}

Haimeur C. ^{[1
]}

Azendour H. ^{[1
]}

机构：

[1] Department of Anaesthesiology, Military Hospital Med v Rabat, University of Med v Souissi, Avenue des Nations Unies, Rabat

来源：

Journal of Medical Case Reports | / 8卷 / 1期

关键词：

Abdominal hypertension; Anesthesia; Ascites; Demons-Meigs' syndrome; Pleural effusion;

D O I：

10.1186/1752-1947-8-320

中图分类号：

学科分类号：

摘要：

Introduction. Demons-Meigs' syndrome is characterized by the presence of a benign ovarian tumor associated with ascites and a right-sided hydrothorax. Its pathophysiology remains unclear. Anesthesia of this syndrome is a real challenge. Respiratory, hemodynamic, metabolic problems and abdominal hypertension are the main anesthetic risks.; Case presentation. A 52-year-old African woman with Demons-Meigs' syndrome was admitted for elective surgery under general anesthesia. An abdominal computed tomography scan showed a tumor mass, with tissue and cystic components associated with abundant ascites and a right pleural effusion of medium abundance. In the operating room after standard monitoring, a crash induction was performed. Just after, her saturation level decreased requiring the use of an alveolar recruitment maneuver followed by the application of positive end-expiratory pressure. Vasoconstrictor and vascular filling were used to correct the hypotension that occurred. Airway pressures remained at 35cm H2O. Maintenance of a slightly proclive position and opening of the abdomen with the progressive removal of 3200ml ascitic fluid allowed a lower thoracic pressure (airway pressures=24cm H2O). Her postoperative course was unremarkable. Clinical evolution after five months was marked by a complete recovery of our patient and no recurrence of effusion or ascites.; Conclusions: Demons-Meigs' syndrome is a benign disease with a good prognosis. Respiratory and hemodynamic problems and abdominal hypertension are the main anesthetic risks of this syndrome. Good management of these risks is necessary to preserve the prognosis. © 2014Fjouji et al.; licensee BioMed Central Ltd.

引用

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