This case involves a 43-year-old man who had been diagnosed as having Charcot-Marie-Tooth disease (CMTD) 9 years ago and was scheduled to undergo posterior fusion of its spine due to a compression fracture. General anesthesia using propofol was selected as the anesthetic method, in order to avoid the occurrence of malignant hyperthermia due to inhalation anesthetics. The patient was given 100 mg of propofol for anesthetic induction, and then propofol was infused at a rate of 4-5 mg/kg/h with intermittent administration of fentanyl for anesthetic maintenance. Rocuronium 50 mg was injected for endotracheal intubation, and then rocuronium 10 mg was injected at 45 min intervals. There was no delay in awakening, and the patient experienced no problems postoperatively. Intravenous anesthesia using propofol is thought to be a safe and effective method of anesthesia for patients with CMTD.
Adult ; Anesthesia ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics, Inhalation ; Charcot-Marie-Tooth Disease* ; Fentanyl ; Fractures, Compression ; Humans ; Intubation, Intratracheal ; Malignant Hyperthermia ; Propofol* ; Spine

Blood-borne metastatic involvement of the gastric mucosa as a result of cancer is a rare occurrence. The tumors which were most commonly reported to metastasize to the stomach include melanoma, breast carcinoma, and lung carcinoma. Some reports document that large cell carcinoma and squamous cell carcinoma of the lungs have a higher pre- dilection for gastrointestinal tract metastases. Upper gastrointestinal endoscopic findings of metastatic lesions may vary but often produce a characteristic single or multiple bulls eye or target lesion. Therefore, whenever single or multiple target lesions are seen in the stomach on upper gastrointestinal endoscopy or barium study, the examination should include careful radiographic evaluation of the chest. Moreover, when the patient is known to have lung cancer, metastatic disease should be suspected. With a correct diagnosis and proper treatment, relief of symptoms and prolongation of life can sometimes be achieved, A case in reported involving squamous cell lung cancer with stomach metastasis in a 73 year-old woman. The patient was diagnosed by bronchoscopy, upper gastrointestinal endoscopy, chest CT, and abdominal CT. The chest and abdominal CT revealed a poorly marginated, lobulated, and 4 x 3 cm sized mass lesion in the right lower lobe causing obstruction of right lower lobe bronchus with invasion to the left atrium. right inferior pulmonary vein, and superior vena cava. Mediastimal lymph node enlargement and liver metastasis was also detected. Upper gastrointestinal endoscopy showed two "bulls eye" lesions with different sizes and two nodules without tip ulceration.
Aged ; Barium ; Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Heart Atria ; Humans ; Life Support Care ; Liver ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis* ; Pulmonary Veins ; Stomach* ; Thorax ; Tomography, X-Ray Computed ; Ulcer ; Vena Cava, Superior

Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature.
Anti-Bacterial Agents ; Esophageal Perforation ; Foreign Bodies ; Humans ; Parenteral Nutrition