ALTMAN TYPE 3 SACROCOCCYGEAL TERATOMA RESECTION IN A NEONATE- AN ANAESTHETIC CHALLENGE

• Published in: Journal of evolution of medical and dental sciences Vol. 6; no. 17; pp. 1388 - 1390
• Main Authors: Mallick, Suchismita, Swaika, Sarbari, Ghosh, Sarmila, Choudhury, Pijush Kanti
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 27.02.2017
• Subjects: Care and treatment; Case studies; Diagnosis; Neonatal diseases; Teratoma
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2017/303

BACKGROUND Sacrococcygeal teratoma (SCT) is the commonest tumour in neonates occurring in 1: 40,000 births. Early removal of the tumour is advised in neonates as there is increased chance of malignant transformation with age. There are several reports on the haemorrhage associated with the tumour, complications of massive blood transfusion and even cardiac arrest in neonates. Here, we present successful anaesthetic management in a similar case of type 3 sacrococcygeal tumour resection in a 3.6 kg full term female child with vascular injury resulting in massive haemorrhage in operation theatre. Despite intractable haemorrhage, the child was saved with momentary clamping of internal iliac artery along with adequate intravenous fluid and blood transfusion. Child was on ventilatory support for 5 days postoperatively and finally extubated when she was maintaining well with oxygen saturation of 97% in room air. SCT resection is associated with problems like massive haemorrhage, coagulopathy, hypothermia, hyperkalaemia, ventilatory difficulties and features of hydrops that is due to high output cardiac failure. Apart from the considerations of neonatal anaesthesia, there should be anticipation of these problems and preparation of emergency medications and requisition of blood and blood products need to be done. KEYWORDS Sacrococcygeal Teratoma, Massive Haemorrhage, Blood Transfusion.