Solunum Sıkıntısının Nadir Bir Nedeni: Plonjan Guatr

Abstract

Giriş: Plonjan guatr, tiroid bezinin mediasten içinde uzanması olarak tanımlanır. Hastalarda nadiren de olsa vokal kord paralizisi, büyük damar basısına bağlı vena kava süperior sendromu ve horner sendromu görülebilir. Olgu Sunumu: Yetmiş yedi yaşındaki bayan hasta, nefes darlığı, yüzde kızarıklık ve şişlik nedeniyle acil servise başvurdu. Hastanın fizik muayenesinde; nabız: 135/dk, tansiyon arteriyal: 140/90 mmHg, solunum sayısı: 28/dakika, SpO2 : %88 idi. Boyun venöz dolgunluğu artmış, her iki troid lobu palpabl, sağ akciğerde solunum sesleri azalmıştı. Kontrastlı toraks tomografisinde (CT) Plonjan guatr izlendi. Tedavide nazal O2 4 L/dk, budenosid 200 mcg 3X2 puff, metilprednizolon 250 mg iv. başlandı. Sonuç: Dispne ile gelen hastalarda retrosternal (plonjan) guatr olasılığı da düşünülmelidir.

Keywords

• Plonjan guatr, vena kava superior sendromu, acil servis

An Unusual Case of Dyspnea: Substernal Goiter

Abstract

Introduction: Substernal thyroid goiter is defined as extension of the thyroid gland into the mediastinum. Vocal cord paralysis, vena cava superior syndrome due to the compression on major vessels, and Horner syndrome can be rarely seen in patients.Case Report: A 77-year-old female patient presented to our emergency department with complaints of dyspnea, flushing, and edema on her face. Her vital signs were as follows: BP: 140/90 mm Hg, HR: 135 bpm, respiratory rate: 28 per minute, and SpO2: 88%. On her physical examination, there was increased jugular venous distension, both thyroid lobes were palpable, and breath sounds decreased in the right lung. A contrast-enhanced pulmonary computed tomography (CT) was planned, and substernal goiter was seen on CT. Then, 4 L/min supplemental O2, 2 puffs of 200 mcg budenoside 3 times a day and 250 mg IV methylprednisolone therapy were started.Conclusion: In patients presenting with dyspnea, retrosternal (substernal) goiter should also be considered

Keywords

• Substernal goiter, vena cava superior syndrome, emergency service

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