TACC diagnosed by transoesophageal endoscopic ultrasonography:A case report

BACKGROUND Primary adenoid cystic carcinoma in the trachea(TACC)is a rare tumour.Tracheal bronchoscopy is always chosen as a routine approach to obtain a pathological diagnosis,but it can be associated with an increased risk of asphyxia.CASE SUMMARY We describe a case of TACC in a patient evaluated by chest computed tomography(CT)with three-dimensional reconstruction imaging and diagnosed by transoesophageal endoscopic ultrasonography.The pathological diagnosis confirmed tracheal adenoid cystic carcinoma.CONCLUSION We highlight the importance of CT and provide a successful exploration of transoesophageal biopsy as a safe alternative approach.

Transoesophageal echocardiography during liver transplantation

Liver transplantation(LT) has become the standard of care for patients with end stage liver disease. The allocation of organs, which prioritizes the sickest patients, has made the management of liver trans-plant candidates more complex both as regards their comorbidities and their higher risk of perioperative complications. Patients undergoing LT frequently display considerable physiological changes during the pro-cedures as a result of both the disease process and the surgery. Transoesophageal echocardiography(TEE), which visualizes dynamic cardiac function and overall contractility, has become essential for perioperative LT management and can optimize the anaesthetic management of these highly complex patients. More-over, TEE can provide useful information on volume status and the adequacy of therapeutic interventions and can diagnose early intraoperative complications, such as the embolization of large vessels or development of pulmonary hypertension. In this review, directed at clinicians who manage TEE during LT, we show why the procedure merits a place in challenging anaesthetic environment and how it can provide essential information in the perioperative management of compromised patients undergoing this very complex surgical procedure.

A 3-dimensional transoesophageal echocardiography perspective of mitral valve abscess

An 85-year-old female with history of dementia presented with concern for severe sepsis and was found to have methicillin sensitive staphylococcus aureus bacteremia complicated by atrial fibrillation.For further workup,a transoesophageal echocardiography(TOE)was obtained.The study revealed a large echogenic density with multiple echolucent areas within the finding.There was evidence of blood flow in these echolucent areas based on color flow imaging.This mass was intermittently protruding into the left ventricle causing a function mitral stenosis.The collective findings on echocardiography,in context of bacteremia,were highly suggestive of mitral valve abscess(Figure 1).

Surgical treatment of left-sided renal carcinoma with grade II inferior vena cava tumour thrombus: a report and review of the literature

The surgical removal of renal cancer,along with the thrombectomy of the inferior vena cava tumour thrombus,represents a remarkable milestone in urological surgery.This procedure is not only technically demanding but also requires a high level of surgical expertise.Managing renal cancer combined with a vena cava tumour thrombus poses significant challenges,especially when dealing with combined grade Ⅱ-Ⅳ inferior vena cava tumour thrombus.The complexity of these cases is further exacerbated by the delicate anatomical structures involved and the need to preserve critical vessels while effectively removing the tumour.The Upper Urethral Tumour Treatment Centre of Weifang People's Hospital successfully treated a challenging case of left renal tumour combined with grade II inferior vena cava tumour thrombus.The surgical team,led by experienced urological surgeons,meticulously planned and executed the procedure,ensuring minimal trauma to the patient and complete removal of the tumour.This achievement not only demonstrates the hospital's commitment to providing state-of-the-art surgical care but also highlights the importance of continued research and training in urological oncology.The successful outcome of this case is a testament to the expertise and dedication of the medical team and offers hope to patients facing similar complex surgical challenges.

Real-time three dimensional transoesophageal echocardiography guided non-coronary intervention procedures: Seeing is believing

Background Real-time Three-dimensional Transoesophageal Echocardiography （RT-3D-TEE） is a huge advance in cardiac ultrasonography, which overcomes many disadvantages of the transthoracic echocardiography. By providing real-time volume image with high resolution, RT-3D TEE offers unique views of cardiac structures, and it has been applied more and more as the guidance in the catheter lab. This article reviewed the recent practice of RT-3D TEE in non-coronary intervention procedures.

Large Anterior Mediastinal Mass: Intraoperative Transesophageal Echocardiography Guided Evaluation and Management

The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guiding aspiration and surgical resection of the cystic mass. Therefore, through this case report, authors emphasize the importance of performing intraoperative real-time TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.