A pediatric patient with a mediastinal mass and pulmonary embolus


  • Poster presentation at the Society for Pediatric Anesthesia Meeting, October 2003.

Dr Laura L. Burgoyne, Division of Anesthesiology, Mail Stop 751, St Jude Children's Research Hospital, 332 N. Lauderdale St, Memphis, TN 38105 2794, USA (email: laura.burgoyne@stjude.org).


When anesthetizing a patient with an anterior mediastinal mass, sudden hypoxaemia and cardiovascular collapse may result from compression of a large airway or vascular structure in the mediastinum. We report the case of a pediatric cancer patient with an anterior mediastinal mass, who developed sudden and fatal hypoxaemia and cardiovascular collapse in the hours following sedation. A massive pulmonary thromboembolism was diagnosed at autopsy. We suggest that pulmonary embolism should be considered in the differential diagnosis when a patient with a mediastinal mass develops perioperative hypoxaemia, cardiovascular collapse, or both.