Anesthetic Management of a Pregnant Patient With a Large Anterior Mediastinal Mass Undergoing Diagnostic Bronchoscopy: A Case Report

TL;DR

A 28-year-old pregnant woman with a large chest mass safely underwent a diagnostic procedure using a specialized intubation method.

Contribution

Demonstrates the successful use of awake fiberoptic intubation in a pregnant patient with a complex mediastinal mass.

Findings

Awake fiberoptic intubation was safely performed in a pregnant patient with a large anterior mediastinal mass.

The procedure ensured airway safety for both the mother and fetus during diagnostic mediastinoscopy.

A multidisciplinary approach was critical for managing the complex airway and vascular risks.

Abstract

This case report details the successful use of awake fiberoptic intubation in a 28‐year‐old pregnant patient at 21 weeks gestation, who presented for diagnostic mediastinoscopy with biopsy secondary to a large anterior mediastinal mass suspected to be lymphoma. MRI displayed encasement of the superior mediastinal vasculature and 13.0 cm × 7.6 cm coalescence in the anterior mediastinum. Given the size of the mass and potential for airway and vascular complications, awake fiberoptic intubation was chosen to ensure safety for both mother and fetus. The case underscores the efficacy of awake fiberoptic intubation in complex airway management scenarios in pregnant patients, highlighting the importance of a multidisciplinary approach to optimize patient care and outcomes.

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