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Surgical nuances giant encephalocele

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Surgical nuances in operating open a giant occipital encephalocele

Text of Surgical nuances giant encephalocele

  • 1. GIANT OCCIPITAL ENCEPHALOCELE FTNVD MALE CHILD PRESENTED AT 15 DAYS OF AGE O/E: Head Circumference: 31cm Encephalocele circumference: 56cm

2. ANESTHETISTS CONSIDERATIONS Difficult intubation Hypothermia (maintenance of temp) Fluid/Blood loss 3. INTRAOPERATIVE POSITIONING 4. ASPIRATION OF THE ENCEPHALOCELE 5. SAC DISSECTION 6. CLOSURE Multilayer closure Arachnoid Dura (Double breasting) Cranioplasty Two layer muscle closure 7. CRANIOTOMY FOR ASSOC CRANIOSYNOSTOSIS 8. POSTOPERATIVE COURSE Pt shifted to ICU intubated, in incubater Had severe hypothermia(29 . C)-Warmed Cyanosed-no peripheral pulse & low BP Extubated 12 hours later Further recovery uneventful 9. GIANT ENCEPHALOCELE COMPLICATIONS Postoperative hydrocephalus requiring shunt 4 Postoperative meningitis 4 POST OPERATIVE MORTALITY: Fulminant meningitis 2 Postoperative brain abscess 1 Post operative hypothermia 1