Enlargement of Intrathoracic Goiter with Unilateral Phrenic Nerve Paralysis Leading to Cardiopulmonary Arrest |
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| Authors: | Nobuki Shioya Nozomu Inoue Naonori Kawashima Yuki Tsukamoto Miyabi Nakayama Koji Hazama Yasuo Shichinohe Fumiyuki Suzuki Naotake Honma |
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| Institution: | 1.Critical Care and Emergency Center, National Hospital Organization Hokkaido Medical Center, Japan; 2.Department of Otorhinolaryngology, National Hospital Organization Hokkaido Medical Center, Japan; 3.Department of Respiratory Surgery, National Hospital Organization Hokkaido Medical Center, Japan |
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| Abstract: | As an intrathoracic goiter expands, it causes airway stenosis and phrenic nerve paralysis, and slight respiratory stimuli can trigger sudden life-threatening hypoventilation. A 78-year-old obese woman with a large intrathoracic goiter was found unconscious with agonal breathing in her room early in the morning. Cardiopulmonary resuscitation restored spontaneous circulation. She underwent surgical removal of the goiter; however, she required long-term mechanical ventilation because of atelectasis due to phrenic nerve paralysis. In patients with large intrathoracic goiters, difficulty breathing on exertion and diaphragm elevation on chest X-ray may be significant findings predicting future respiratory failure. |
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| Keywords: | cardiopulmonary arrest intrathoracic goiter phrenic nerve paralysis |
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