Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital

Joseph Akodjènou; Abdel-Kémal Bori Bata; Antoine Séraphin Gbénou; Médard Guedenon; Morgiane Houngbadji; Eulalie Sansuamou; Maroufou Jules Alao; Eugène Zoumènou; Jean Etienne Bazin; Francis Veyckemans

doi:doi:10.11648/j.ajp.20210704.13

Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital

Joseph Akodjènou, Abdel-Kémal Bori Bata, Antoine Séraphin Gbénou, Médard Guedenon, Morgiane Houngbadji, Eulalie Sansuamou, Maroufou Jules Alao, Eugène Zoumènou, Jean Etienne Bazin, Francis Veyckemans

Published in American Journal of Pediatrics (Volume 7, Issue 4)

Received: 30 September 2021 Accepted: 19 October 2021 Published: 28 October 2021

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Abstract

Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO₂, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.

Published in	American Journal of Pediatrics (Volume 7, Issue 4)
DOI	10.11648/j.ajp.20210704.13
Page(s)	198-202
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fetus in Fetus, Chest Mass, Anesthetic Management, Infant

References

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[2]	Lord JM. Intra-abdominal foetus in foetu. J Pathol Bacteriol 1956; 72: 627-41.
[3]	Lindsey M. Prescher, William J. Butler, Tyler A. Vachon, Marion C. Henry, Thomas Latendresse, Romeo C. Ignacio Jr. Fetus in fetu: Review of the literature over the past 15 years; Journal of Pediatric Surgery CASE REPORTS, J Ped Surg Case Reports 3 (2015) 554-562.
[4]	Reddy RK, Kannaiyan L, Srirampur S, Malleboyina R, Irfan GM, Sharab H, Kannepalli S. Thoracic fetus in fetu. J Indian Assoc Pediatr Surg. 2012; 17 (4): 178-9.
[5]	Hoeffel CC, Nguyen KQ, Phan HT, Truong NH, Nguyen TS, Tran TT, et al. Fetus in fetu: a case report and literature review. Pediatrics 2000; 105: 1335-44.
[6]	Phatak. Fetus-in-fetu: a case report. Indian J Radiol Image 2003; 13: 93-4.
[7]	Barrier G, Mayer MNB, Amiel-Tison C et al. Measurement of post-operative pain and narcotic administration in infants using a new clinical scoring system; Intensive Care Med 1989; 15: 37-9.
[8]	Escobar MA, Rossman JE, Caty MG. Fetus-in-fetu: report of a case and a review of the literature. J Pediatr Surg 2008; 43: 943-6.
[9]	Hing A. Corterville J. Foglia RB, Bliss Jr DP, Dollis – Keller H, Dowton SB. fetus in fetu: molecular analysis of a fetiform mass. Am J Med Genet 1993; 47: 333-41.
[10]	Grosfeld JL, Stepita DS, Nance WE, Palmer CG. Fetus in fetu: An usually cause for abdominal mass in infancy. Ann Surg 1974; 180: 80-4.
[11]	Khadaroo RG, Evans MG, Honore LH, Bhargava R, Phillipos E. Fetus in fetu pressing as cystic meconium peritonitis: diagnosis, pathology, and surgical management. J Pediatr Surg 2000; 35: 731-3.
[12]	Chua JH, Chui CH, Sai Prasad TR, Jabcobsen, AS, Meenakshi A, Hwang WS. Fetus in fetu in the pelvis: report of case and literature review. Ann Acad Med Singapour 2005; 34: 646-9.
[13]	Kim JW, Park SH, Park SS, Wang KC, Cho BK, Kim SY, and al. Fetus in fetu in the cranium of a 4 month-old boy: histopathology and short tandem repeat polymorphism- based genotyping. Case report. J Neurosurg Pediatr 2008; 1: 410-4.
[14]	Spencer R. Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs). Clin Anat 2001; 14: 428-44.
[15]	Ji Y, Chen S, Zhong L, Jiang X, Jin S, Kong F, Wang Q, Li C, Xiang B. Fetus in fetu: two case reports and literature review. BMC Pediatr. 2014; 14: 88.

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APA Style

Joseph Akodjènou, Abdel-Kémal Bori Bata, Antoine Séraphin Gbénou, Médard Guedenon, Morgiane Houngbadji, et al. (2021). Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. American Journal of Pediatrics, 7(4), 198-202. https://doi.org/10.11648/j.ajp.20210704.13

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ACS Style

Joseph Akodjènou; Abdel-Kémal Bori Bata; Antoine Séraphin Gbénou; Médard Guedenon; Morgiane Houngbadji, et al. Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. Am. J. Pediatr. 2021, 7(4), 198-202. doi: 10.11648/j.ajp.20210704.13

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AMA Style

Joseph Akodjènou, Abdel-Kémal Bori Bata, Antoine Séraphin Gbénou, Médard Guedenon, Morgiane Houngbadji, et al. Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. Am J Pediatr. 2021;7(4):198-202. doi: 10.11648/j.ajp.20210704.13

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@article{10.11648/j.ajp.20210704.13,
  author = {Joseph Akodjènou and Abdel-Kémal Bori Bata and Antoine Séraphin Gbénou and Médard Guedenon and Morgiane Houngbadji and Eulalie Sansuamou and Maroufou Jules Alao and Eugène Zoumènou and Jean Etienne Bazin and Francis Veyckemans},
  title = {Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital},
  journal = {American Journal of Pediatrics},
  volume = {7},
  number = {4},
  pages = {198-202},
  doi = {10.11648/j.ajp.20210704.13},
  url = {https://doi.org/10.11648/j.ajp.20210704.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210704.13},
  abstract = {Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO2, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.},
 year = {2021}
}

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TY - JOUR
T1 - Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital
AU - Joseph Akodjènou
AU - Abdel-Kémal Bori Bata
AU - Antoine Séraphin Gbénou
AU - Médard Guedenon
AU - Morgiane Houngbadji
AU - Eulalie Sansuamou
AU - Maroufou Jules Alao
AU - Eugène Zoumènou
AU - Jean Etienne Bazin
AU - Francis Veyckemans
Y1 - 2021/10/28
PY - 2021
N1 - https://doi.org/10.11648/j.ajp.20210704.13
DO - 10.11648/j.ajp.20210704.13
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 198
EP - 202
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20210704.13
AB - Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO2, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.
VL - 7
IS - 4
ER -

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Author Information

Joseph Akodjènou

Resuscitation Anesthesia Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Abdel-Kémal Bori Bata

Pediatric Surgery Department Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Antoine Séraphin Gbénou

Pediatric Surgery Department Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Médard Guedenon

Pediatric Surgery Department Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Morgiane Houngbadji

Pediatric Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Eulalie Sansuamou

Radiology Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Maroufou Jules Alao

Pediatric Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Eugène Zoumènou

Resuscitation Anesthesia Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin
Jean Etienne Bazin

Resuscitation Anesthesia Department, Estaing University Hospital Center, Clermont, Ferrand, France
Francis Veyckemans

Resuscitation Anesthesia Department, Regional University Hospital Center, Lille, France

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Plain Text BibTeX RIS

APA Style

Joseph Akodjènou, Abdel-Kémal Bori Bata, Antoine Séraphin Gbénou, Médard Guedenon, Morgiane Houngbadji, et al. (2021). Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. American Journal of Pediatrics, 7(4), 198-202. https://doi.org/10.11648/j.ajp.20210704.13

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ACS Style

Joseph Akodjènou; Abdel-Kémal Bori Bata; Antoine Séraphin Gbénou; Médard Guedenon; Morgiane Houngbadji, et al. Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. Am. J. Pediatr. 2021, 7(4), 198-202. doi: 10.11648/j.ajp.20210704.13

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AMA Style

Joseph Akodjènou, Abdel-Kémal Bori Bata, Antoine Séraphin Gbénou, Médard Guedenon, Morgiane Houngbadji, et al. Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital. Am J Pediatr. 2021;7(4):198-202. doi: 10.11648/j.ajp.20210704.13

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@article{10.11648/j.ajp.20210704.13,
  author = {Joseph Akodjènou and Abdel-Kémal Bori Bata and Antoine Séraphin Gbénou and Médard Guedenon and Morgiane Houngbadji and Eulalie Sansuamou and Maroufou Jules Alao and Eugène Zoumènou and Jean Etienne Bazin and Francis Veyckemans},
  title = {Anesthetic Management of an Intrathoracic Fetus in Fetus Case in a 5 Months Old Infant at a Low Resources African Sub-saharan Hospital},
  journal = {American Journal of Pediatrics},
  volume = {7},
  number = {4},
  pages = {198-202},
  doi = {10.11648/j.ajp.20210704.13},
  url = {https://doi.org/10.11648/j.ajp.20210704.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210704.13},
  abstract = {Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO2, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.},
 year = {2021}
}

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