Anaesthetic Challenges in Paediatric Hepatoblastoma Resection: A Case Report

Abstract

The most common primary liver tumour in children is hepatoblastoma, which is often diagnosed in the first three years of life. While the majority of hepatoblastomas are sporadic, some associations are reported with genetic disorders like Beckwith-Wiedemann syndrome and familial adenomatous polyposis. The annual incidence of hepatoblastoma in children has gradually increased during the past three decades. Babies born prematurely, weighing <1 kg, have been found to be significantly more likely to acquire hepatoblastoma. The most common symptoms with which children present are abdominal discomfort, easy fatigability, loss of appetite, and anaemia. The choice of treatment is surgical resection of the mass or surgical resection coupled with chemotherapy. Present case is of a seven-month-old, 7 kg infant who presented with a gradually increasing abdominal mass diagnosed as hepatoblastoma. Left hepatectomy was done under general anaesthesia and epidural analgesia. Liver resection is one of the major surgical procedures that carries a risk of blood loss and pulmonary embolism, but improved expertise in paediatric anaesthesia and surgical skills have reduced operative risk. The challenges in this case were securing vascular access, maintaining blood volume with considerable fluid and blood loss, and assuring haemodynamic stability. Maintenance of normothermia, glucose levels, and effective pain management were all crucial, necessitating careful planning and a multidisciplinary approach to maximise results and guarantee patient safety.

Keywords

• anaesthesia
• epidural analgesia
• hepatectomy