Anesthetic considerations in Demons-Meigs' syndrome: a case report.

Abstract

INTRODUCTION:

Demons-Meigs' syndrome is characterized by the presence of a benign ovarian tumor associated with ascites and a right-sided hydrothorax. Its pathophysiology remains unclear. Anesthesia of this syndrome is a real challenge. Respiratory, hemodynamic, metabolic problems and abdominal hypertension are the main anesthetic risks.

CASE PRESENTATION:

A 52-year-old African woman with Demons-Meigs' syndrome was admitted for elective surgery under general anesthesia. An abdominal computed tomography scan showed a tumor mass, with tissue and cystic components associated with abundant ascites and a right pleural effusion of medium abundance. In the operating room after standard monitoring, a crash induction was performed. Just after, her saturation level decreased requiring the use of an alveolar recruitment maneuver followed by the application of positive end-expiratory pressure. Vasoconstrictor and vascular filling were used to correct the hypotension that occurred. Airway pressures remained at 35 cm H2O. Maintenance of a slightly proclive position and opening of the abdomen with the progressive removal of 3200 ml ascitic fluid allowed a lower thoracic pressure (airway pressures=24 cm H2O). Her postoperative course was unremarkable. Clinical evolution after five months was marked by a complete recovery of our patient and no recurrence of effusion or ascites.

CONCLUSIONS:

Demons-Meigs' syndrome is a benign disease with a good prognosis. Respiratory and hemodynamic problems and abdominal hypertension are the main anesthetic risks of this syndrome. Good management of these risks is necessary to preserve the prognosis.

• Authors: Salaheddine Fjouji, Mustapha Bensghir, Charki Haimeur, Hicham Azendour
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 8 Pg. 320 (Sep 27 2014) ISSN: 1752-1947 [Electronic] England
• PMID: 25262179 (Publication Type: Case Reports, Journal Article)

Topics

• Anesthesia, General (methods)
• Female
• Humans
• Meigs Syndrome (diagnosis, surgery)
• Middle Aged