The Role of Ultrasound for Diagnosis and follow-up of a Pediatric Patient with acute Appendicitis and Melas syndrome

V. Tasseva(1), E. Ilieva(1), S. Stoilov(2), M. Totev(1), G. Garvanska(1)
1 Depatment of Diagnostic Imaging
2 Department of Paediatric Surgery UMHATEM Pirogov, Sofia, Bulgaria

Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a progressive neurodegenerative disorder caused by mutations in the genes in the mitochondrial DNA. Nowadays there are more than 200 mitochondrial mutations proved to cause different types of disorders. Mitochondrial disease may become clinically apparent once the number of affected mitochondria reaches a certain level; this phenomenon is called “threshold expression”. The symptoms result from the organs with the highest energy demands – brain, lungs, liver, kidneys and heart, but other organs and systems are also affected. The use of general anaesthesia when surgical interventions are performed carries out a high risk for the patients and could be life threatening due to dangerous occurrence of hyperthermia or hypothermia. Patients with MELAS syndrome could either be resistant to myorelaxant drugs or experience their prolonged effect. Different schemes of anaesthetics used for patients with MELAS syndrome without complications have been reported, however, no safe and uniform scheme currently exists.

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