PMID: 15334404Aug 31, 2004Paper

Report of an obstructive goiter and its surgical treatment during delivery

American Journal of Otolaryngology
Todd W PrestonBrendan C Stack

Abstract

We report a case of a morbidly obese young woman in her third trimester of pregnancy presenting with a history of goiter and respiratory disease. The recent history of this patient was significant for worsening respiratory symptoms over a period of 2 weeks, and, on presentation at 36 weeks gestation, she was stridorous, dyspneic at rest, and had a hoarse voice. Evaluation revealed a morbidly obese individual with a large goiter. She was biochemically euthyroid. Fiberoptic laryngoscopy revealed a left true vocal cord paresis, and ultrasound evaluation was significant for diffuse multinodular enlargement, with each lobe measuring greater than 10 cm and the isthmus measuring 5. Pulmonary function testing revealed a significant degree of upper airway obstruction without significant lower airway disease. Given the patient's clinical signs and symptoms, her tenuous airway, poor candidacy for urgent tracheotomy, and her proximity to delivery, it was agreed that the patient should undergo elective cesarean section and at its completion undergo subtotal thyroidectomy for the obstructive goiter.

Citations

Sep 3, 2013·International Journal of Obstetric Anesthesia·M A Hendrie, M M Kumar
Feb 21, 2006·Thyroid : Official Journal of the American Thyroid Association·K AloumanisC H Kostopoulos
Dec 6, 2005·International Journal of Obstetric Anesthesia·C I OkekeA Adesida
Mar 21, 2009·Anesthesia and Analgesia·Bernard WittelsMatthew P Jaycox
Aug 7, 2019·BMJ Case Reports·Guo Hou LooMawaddah Azman
Aug 28, 2021·Annals of the Royal College of Surgeons of England·C A Efthymiou

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