Essence of Anesthesia Practice

Mediastinal Masses

Acknowledgment I wish to thank Dr. Frank Gencorelli for his work on this chapter in the earlier edition of this book. Risk Usually a congenital lesion, occurring at 1:5000; no gender bias Benign or malignant; cysts or aneurysms that arise…

Mastocytosis

Risk Rare clinical condition with an estimated incidence at 1:150,000. Perioperative Risks Not an allergic disease. Not a risk factor of IgE-mediated drug allergy. Mast cell degranulation induced by various nonspecific triggers with subsequent histamine and other mediators (e.g., tryptase,…

Marfan Syndrome

Risk Prevalence is estimated at 1:5000 people. Inherited as autosomal dominant trait, though 25% of cases are sporadic. The 2010 Ghent Nosology for Marfan Syndrome guides Dx, heavily prioritizing aortic root dilation, ectopia lentis, and family history. Perioperative Risks Aortic…

Malnutrition

Risk Rate approximately 5% in general population and 10–20% in surgical pts; increases to 40% or more in severely ill hospital admissions. Risk increases with severity of underlying disease, presence of malignancy (especially GI), and advancing age (in older [>75…

Lysosomal Storage Disorders

Risk Individually rare, but as a group the incidence is approximately 1:8000. Perioperative Risks Difficult airway management Cardiac or respiratory failure Hemorrhage Worry About Difficult or failed intubation Coexisting cardiac or respiratory disease Difficult vascular access Neurologic involvement and pt…

Lymphomas

Risk 5.3% of all cancers; 55.6% of all blood cancers (USA National Institutes of Health Registry) Per annum risk 2.9:100,000 population (European Age-Standardized Incidence UK, 1993–2012) Perioperative Risks Tumor: Mechanical obstruction, compression effect on organs systems (e.g., airway or bowel…

Lyme Disease

Risk Approximately 30,000 new cases are reported to the CDC each year; however, this number is likely underestimated. The CDC is currently conducting research, and preliminary results suggest the number of new cases to be around 300,000. Lyme disease is…

Ludwig Angina

Risk Main risk factor is odontogenic infection, especially of the second and third molars (90% of all cases). Other factors include dental and gingival disorders, bacterial infection of the floor of the mouth, peritonsillar abscess, IV drug abuse, mandible fracture,…

Long QT Syndrome

Risk Prevalence of cLQTS: Approximately 1:5000 live births. Incidence of cLQTS: 1 in 10,000. 60–70% of those diagnosed are females. Males under 10 y of age have the highest mortality. Pts usually present in childhood with a cardiac event. Perioperative…