Our Unpredicted Difficult Airway Experience in Tracheobronchopathia Osteochondroplastica Patient: A Case Report

Difficult airway is a serious condition that can be fatal and is frequently encountered during general anesthesia applications. Tracheobronkopathy osteochondroplasty (TBO) is a rare benign disease that is one of the causes of unpredictable difficult airway. A 45-year-old male patient with no comorbidities was transferred to the operating room for elective cholecystectomy. He couldn’t be intubated after standard monitoring and induction of anesthesia. The patient, who had papillomatous lesions in the trachea detected by bronchoscopy, was awakened to be scheduled for rigid bronchoscopy. TBO was detected in pathological examination of the samples taken in rigid bronchoscopy. TBO is a rare benign disease. Its etiology is unknown. It may be asymptomatic or may present with persistent dry cough, hemoptysis, dyspnea, recurrent lower respiratory tract infection, atelectasis and difficult intubation. Some patients may be diagnosed for the first time in the operating room due to difficult intubation.In cases with advanced tracheal stenosis, invasive airway intervention may be required or it may have a fatal course. The use of a laryngeal mask in the perioperative period may be an ideal option in a patient known to have TBO before. Unexpected difficult airway management in the operating room is important for anesthesiologists. According to the difficult airway society algorithm, waking the patient from a planned operation is the safest way until the problem is detected. We did not need invasive intervention because our patient also had elective surgery and ventilation was not difficult. In addition, we think that it is an important decision to make a diagnosis using fiberobtic bronchoscopy in operating room conditions and to wake up our patient with sugammadex without repeated attemps of tracheal intubation and delay elective surgery. In coclusion, it should be kept in mind that TBO may be one of the unpredictable causes of difficult intubation in the operating room

Hemolysis After Administration of High-Dose Immunoglobulin in a Patient with Myocarditis

ABSTRACT The use of high-dose intravenous immunoglobulin (IVIG) has greatly increased in the last years. With broader use of immunoglobulin, the numbers of reported side effects are also growing. IVIG have also been used in the treatment of myocarditis and dilated cardiomyopathy. Here we reported a child with presumed acute myocarditis who has developed severe hemolytic anemia following high-dose IVIG administration. As our knowledge, this is the first case report with myocarditis or dilated cardiomyopathy who developed hemolytic anemia following high-dose IVIG administration

Evaluation of Pediatric Immune Thrombocytopenia (ITP) Cases and Risk Factors for Chronic ITP - Single Center Experience

Aim: Immune thrombocytopenia (ITP) is the most common acquired bleeding disorder in childhood. The study aimed to assess the demographic and clinical characteristics, and treatment responses and to evaluate their effects on chronicity in pediatric ITP cases. Material and Methods: Primary ITP patients aged 1 month to 18 years, who were diagnosed and followed up in the Pediatrics Clinic of Tokat Gaziosmanpaşa University Hospital between January 2010 and December 2018, were retrospectively analyzed. Results: Thirty-eight patients with a diagnosis of primary ITP were included in the study. The mean age of the patients was 94.3±53.4 (14-199) months. The female/male ratio was 1. Twenty (57.1%) patients had acute ITP, and 15 (42.9%) patients had chronic ITP. There was no significant difference between the acute ITP group and the chronic ITP group in demographic, clinical features, laboratory findings, and treatment responses. In the first 12 months, the number of admissions with a platelet count o

Evaluation of nasal allergy with symptomatology and skin prick test in the children having chronic otitis media with effusion

In this study, the children, who has chronicotitis media with effusion were investigated according tosymptomatology of allergic rhinitis and skin prick test andcoexistence of allergic rhinitis.Materials and methods: This study included 65 pediatricpatients who consisted of 43 patients with EOM and 22people without otitis media with effusion between October2010 and May 2011. History, physical examination, laboratorywork up was noted to form papers. People werequestioned according to symptomatology of allergic rhinitis.Skin prick tests were done and results were noted.Results: At the end of study, significant differences werefound between groups symptomatologically (p0,05), the frequencyof positive skin prick test were higher in patients thancontrol subjects.Conclusion: When the etiology of chronic otitis mediawith effusion investigated, it must be considered that patientsshould be questioned for allergic rhinitis.Key words: Otitis media with effusion, allergic rhinitis,skin prick tes