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Hidden bifid spine at preanaesthetic consultation
Detección de espina bífida oculta en la consulta de preanestesia
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Mesa Suárez, C. Montes Durán, F.J. Hidalgo Ramos, M.L. Calvo Castilla" "autores" => array:4 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Mesa Suárez" "email" => array:1 [ 0 => "mesa.pms@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Montes Durán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "F.J." "apellidos" => "Hidalgo Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M.L." 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The arrow shows the posterior lumbosacral dysraphism.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 32-year-old obese (weight 85<span class="elsevierStyleHsp" style=""></span>kg, height 165<span class="elsevierStyleHsp" style=""></span>cm, BMI 31) woman with hypothyroidism (150<span class="elsevierStyleHsp" style=""></span>μg/daily levothyroxine) was seen in the pre-anaesthesia clinic for perianal fistula repair. The physical examination revealed a midline lumbosacral lipoma covered by sparse fine black hair, which the patient reported had been present since birth (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Given the suspicion of spina bifida, a nuclear magnetic resonance study was requested, which confirmed our suspicion: cord tethered at L3, with extramedullary intrathecal lipoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and posterior lumbosacral dysraphism (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The patient was informed about this incidental finding, and about the relative contraindication of locoregional anaesthesia due to the risks associated with both this surgical procedure and obstetric epidural (incomplete block, subdural block, spinal cord trauma, spinal haematoma, accidental dural puncture) if this should be requested in the future. The patient was referred to Neurosurgery, where a conservative approach was taken due to the absence of clinical symptoms. The patient was given a copy of her pre-anaesthesia assessment report, which described this incidental finding.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mesa Suárez P, Montes Durán C, Hidalgo Ramos FJ, Calvo Castilla ML. Detección de espina bífida oculta en la consulta de preanestesia. Rev Esp Anestesiol Reanim. 2018;65:181–182.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1030 "Ancho" => 1582 "Tamanyo" => 101615 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Photograph of the patient.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2092 "Ancho" => 2833 "Tamanyo" => 354148 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sagittal lumbar magnetic resonance imaging. The arrows show the cord tethered at L3 and the extramedullary intrathecal lipoma.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1584 "Ancho" => 1584 "Tamanyo" => 276139 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Axial lumbar magnetic resonance imaging. The arrow shows the posterior lumbosacral dysraphism.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006500000003/v3_201803240409/S234119291830009X/v3_201803240409/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000003/v3_201803240409/S234119291830009X/v3_201803240409/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119291830009X?idApp=UINPBA00004N" ]
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