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Case Reports
Enlargement of Intrathoracic Goiter with Unilateral Phrenic Nerve Paralysis Leading to Cardiopulmonary Arrest.
- Nobuki Shioya, Nozomu Inoue, Naonori Kawashima, Yuki Tsukamoto, Miyabi Nakayama, Koji Hazama, Yasuo Shichinohe, Fumiyuki Suzuki, and Naotake Honma.
- Critical Care and Emergency Center, National Hospital Organization Hokkaido Medical Center, Japan.
- Intern. Med. 2021 Jan 1; 60 (1): 91-97.
AbstractAs 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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