# Pediatric Graves’ Disease: Challenges Associated With Thyroidectomy and Perioperative Management in a Three-Year-Old Child

## TL;DR

This paper discusses the challenges of performing thyroidectomy in a three-year-old child with rare pediatric Graves’ disease and highlights the need for a multidisciplinary approach.

## Contribution

The paper presents a rare case of pediatric Graves’ disease and emphasizes tailored perioperative strategies for successful thyroidectomy in young children.

## Key findings

- The patient had tachycardia, hypertension, and severe bilateral proptosis preoperatively.
- Airway management was challenging due to tracheal shift and possible tracheomalacia.
- Multidisciplinary care improved outcomes in this complex pediatric case.

## Abstract

Graves’ disease is a rare cause of hyperthyroidism in children, and it poses specific problems in diagnosis and surgery. We report a three-year-old female child who had Graves’ disease with exophthalmos, for which she underwent a total thyroidectomy. On the preoperative assessment, the patient had tachycardia, hypertension, and severe bilateral proptosis. Managing the airway was challenging due to a shift in the trachea and possible tracheomalacia. Endocrine stabilization, protection for the eyes during surgery, and close observation for thyroid storms and neck hematoma were some strategies employed during the perioperative period. This case highlights the importance of tailored, multidisciplinary approaches to optimize outcomes in pediatric thyroidectomy.