A & A case reports
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We describe a case of a thoracic epidural abscess after epidural catheter insertion in a patient undergoing lobar segmentectomy. The patient described a "pulsatile" back pain the sixth day after surgery, and purulent material at the entry site of the catheter was observed. The image of the nuclear magnetic resonance confirmed an epidural abscess that was treated conservatively with antibiotics after a consensus decision among neurosurgery, infectious diseases an anesthesia services. The abscess was reabsorbed completely with no sequelae.
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In this report, we describe a case of posterior reversible encephalopathy syndrome in a female patient after deceased donor liver transplantation. She developed posterior reversible encephalopathy syndrome on postoperative day 3 and did not improve despite adjustments in immunosuppressive therapy. ⋯ Reductions in therapeutic support were ultimately successful after 62 days of continuous pentobarbital therapy. The patient awoke neurologically intact and was discharged to a rehabilitation center in good condition.
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We report a case of a patient undergoing esophagectomy for end-stage achalasia, a rare condition associated with potentially catastrophic ventilatory and circulatory complications. The complexity of the case necessitated preoperative planning with the surgical specialist, development of a novel algorithm for airway management, and careful implementation of our plan. Isolation of the lungs from the esophagus presented unique challenges due to not only the anatomic derangements that are the hallmark of this disease process but also an unusual anatomic finding seen in this patient.