Surgery to remove a rare large goiter compressing the patient's trachea

The 70-year-old man often choked and had severe difficulty breathing due to a large goiter hanging down into the mediastinum, compressing the trachea... The patient was promptly 'rescued' by surgeons.

Thoracic and vascular surgeons at Can Tho General Hospital examine patients after surgery - Photo: BVCC

Information from Can Tho General Hospital said the patient was Mr. NVH (in Co Do district, Can Tho city). After surgery to remove a large goiter, the old man is now stable and no longer has difficulty breathing.

Previously, Mr. H. had intermittent coughs with phlegm, difficulty breathing, and difficulty swallowing. He was often given aerosol sprays at home, which reduced his cough symptoms. However, his difficulty breathing became more severe. He was taken to the local hospital for emergency care, then transferred to Can Tho General Hospital.

At the hospital, the patient appeared cyanotic, lethargic, had severe difficulty breathing, and had respiratory muscle contractions... The emergency team immediately performed an emergency endotracheal intubation on the old man. After examination, the doctor diagnosed Mr. H. with pneumonia and respiratory failure, and a large goiter compressing the trachea.

According to the family, the old man had discovered a goiter many years ago but only treated it with internal medicine, not intervention because Mr. H. had sick sinus syndrome and had a pacemaker. After a long time, the goiter gradually grew larger, making it difficult for him to eat and swallow.

The patient was intubated and put on a ventilator, his difficulty breathing improved, and with intensive medical resuscitation, the patient's condition improved.

The family wanted medical treatment because the old man had comorbidities, sick sinus syndrome, and a pacemaker had been placed. However, after extubation, the patient continued to have labored breathing and struggled with stimulation, so he was reintubated.

The results of the patient's chest CT scan showed that the goiter was large and hanging into the mediastinum, compressing the trachea, causing choking and difficulty breathing. After consulting with multiple specialists, the thoracic surgery, ENT, and anesthesia teams indicated surgery to remove the hanging goiter and open the trachea.

After surgery, the patient's difficulty breathing was reduced and the ventilator was removed, but subcutaneous emphysema appeared at the tracheostomy site. The doctor continued to suture the trachea and place a drainage tube at the surgical site. Currently, the old man's health is stable and recovering well.

According to doctors, this is a rare case of large goiter. Surgical removal is difficult because the goiter is large and hangs down into the mediastinum.

The large tumor compresses the trachea and makes intubation difficult. If the tumor is not surgically removed in time, the patient will continue to have difficulty swallowing and breathing.

Therefore, doctors warn that when a goiter is detected, the patient should go to the hospital for regular check-ups and examinations to receive early treatment intervention.

Source: https://tuoitre.vn/phau-thuat-boc-khoi-buou-giap-to-hiem-gap-chen-ep-khi-quan-nguoi-benh-20250110143603622.htm