Case Report

A 70 year old female, weighing 65 kilogram (kg) was admitted to our hospital with history of right sided abdominal pain, radiating to right shoulder and back since 6 months. Pain was intermittent in nature, not associated with nausea, vomiting, per rectal bleeding, constipation or malena. She was investigated and diagnosed to have giant hemangioma of right lobe of the liver and now posted for right lobe heptectomy.

Patient had no other comorbidities,was a tobacco chewer since 40 years, stopped for last 15 days. She had undergone an uneventful tubal ligation surgery 45 years ago under subarachnoid block.

On general examination patient was conscious, co-operative with baseline parameters: Pulse rate (HR): 90/min, Blood pressure(BP): 130/90mm of Hg,SpO2: 98% (room air).

Airway examination revealed loose and bucked upper incisors, multiple missing teeth in the lower jaw with Mallampati score (MPC) III. Neck movements were normal. Cardiovascular and respiratory systems were unremarkable. Her blood investigations were normal, two dimensional echocardiography (2D echo) revealed left ventricular hypertrophy with ejection fraction 55%, pulmonary artery systolic pressure 32 mmHg. Electrocardiogram (ECG) revealed sinus tachycardia and chest x-ray was normal.

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Dr Rewa Shinde

Assistant Professor in Dept. of Anaesthesiology, D. Y Patil Medical College and hospital, Navi Mumbai