Dear colleagues

The fourth issue of the Greek e-journal of Perioperative Medicine for 2022 presents various case reports concerning perioperative medicine.

The case of Sivrioğlu D et al. presents the perioperative management of an 8-year-old patient with Glycogen storage disease type Ia (GSD type-Ia), with malignant transformation of hepatic adenoma, that underwent liver transplantation. The authors note that the anesthetic management of these patients has important implications for anesthesiologists due to different system involvements.

The case report of Uslu A et al. presents the preparation and management of non-operating room anesthesia (NORA) in an 8-year-old patient diagnosed with VACTERL syndrome (multiple congenital malformations: vertebral, cardiac, tracheo-esophageal, renal and extremity anomalies, cardiac anomaly-large secundum ASD-, right renal agenesis, operated tracheoesophageal fistula and esophageal atresia).

The article of Kandemir E et al. evaluates the anesthetic management and considerations of a glycogen storage disease type 1a pediatric patient with air embolism during liver transplantation. The authors conclude a multidisciplinary approach and care should be taken in terms of limiting the presence of perioperative complications.

Next, the article of Papagiannopoulou O et al. shows that the intraoperative use of transesophageal echocardiogram (TEE) establishes the diagnosis (aneurysm dissection of the ascending aorta, a large thrombus in the false lumen and a bicuspid aortic valve), dictates the final course and exacts the method of the operating process.

The case report of Tuç Ö et al. describes the anesthetic management and preoperative preparation of a patient with hereditary angioedema (HAE), which is a life-threatening, rare, autosomal, dominant disorder. Authors note that this disease is not related to mast cell and histamine pathway and as a result, it does not respond to antihistamines, glucocorticoids, or epinephrine. They also mention that difficult airway management should be kept in mind in case of airway edema.

The final article of Haka D et al. presents the perioperative management of an 8-year-old patient with Crigler Najjar Syndrome (CNS) that underwent a dental procedure, while she was scheduled for upcoming liver transplantation. They conclude that CNS is challenging for anesthesiologists due to the fact that most anesthetic agents may increase serum-free bilirubin levels and also the perioperative complications.

With regards

Editors in chief

Mouloudi Eleni
Papagiannopoulou Pinelopi