Case report, case study
TRACHEOTOMY IN THE TREATMENT OF ORTHOPNEA AS A CONSEQUENCE OF MADELUNG’S DISEASE
STJEPAN GRABOVAC
; Bjelovar General Hospital, ENT Department, Bjelovar, Croatia; University of Bjelovar, Professional Study in Nursing, Bjelovar, Croatia
ĐURĐICA GRABOVAC
; University of Bjelovar, Professional Study in Nursing, Bjelovar, Croatia
GORDANA KESIĆ VALPOTIĆ
; Bjelovar General Hospital, Anesthesiology and Intensive Treatment Department, Bjelovar, Croatia;University of Bjelovar, Professional Study in Nursing, Bjelovar, Croatia
Abstract
The aim of this paper is to present tracheotomy as a therapeutic option in severe orthopnea caused by Madelung’s disease. This paper presents a patient with severe orthopnea as a consequence of advanced Madelung’s disease. The patient had been sleeping in a sitting position for years. Tracheotomy was suggested as a treatment measure. He was satisfied because after more than 20 years, he could breathe calmly and without fear and could sleep in a lying position, which improved his quality of life. Madelung’s disease is a very rare clinical entity of unknown etiology. The characteristic appearance of the patient is a consequence of the excessive, continuous and uncontrolled accumulation of unencapsulated adipose tissue under the skin of the neck, shoulders and upper trunk. Fat deposits rise slowly over years and the initial symptoms are generally of aesthetic nature. Pressurized
fat deposits may cause compressive interference. Diagnosis is easy and confirmed on the basis of medical history and clinical
examination, and computed tomography and magnetic resonance imaging determine the distribution of adipose tissue. The
treatment is mainly surgical. One of the symptoms of long-term Madelung’s disease are breathing problems, and orthopnea is
considered most severe when the patient can only breathe in upright position. In order to prevent the development of orthopnea,
patients should be warned in time about the possible consequences that can occur if Madelung’s disease is not treated on time.
Keywords
tracheotomy; orthopnea; Madelung’s disease
Hrčak ID:
310555
URI
Publication date:
22.11.2023.
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