Poland syndrome: A case of difficult weaning of ventilation after surgery
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Hepatopancreaticobiliary Division, Department of Surgery,Universiti Sains Malaysia, Kelantan, Malaysia
Department of Surgery, Universiti Sains Malaysia, Kelantan, Malaysia
Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Advanced Medical and Dental Institue, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
Submission date: 2023-08-13
Final revision date: 2023-12-31
Acceptance date: 2023-12-31
Online publication date: 2024-02-27
Corresponding author
Ikhwan Sani Mohamad   

Department of Surgery, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Pol. Ann. Med. 2024;31(1):27-29
Poland syndrome is a rare congenital anomaly that occurs in 1 in 30,000 children. It is characterised by unilateral underdevelopment or lack of the chest wall muscle that is apparent at birth. Rarely is it discovered to involve a bilateral chest muscular deficit. Poland syndrome presents in a wide variety of ways, which can often make diagnosis challenging.

We would like to highlight the rarity of Poland syndrome, and the challenges of post-operative recovery, primarily the ventilation.

Case study:
We presented a case of a 44-year-old female with non-investigated chest wall deformity, whom required emergency surgical intervention under general anaesthesia. Post-operatively, she required prolonged ventilatory support, and was then diagnosed with Poland syndrome.

Results and discussion:
The patient had undergone an emergency laparotomy and left lateral hepatectomy for left hepatolithiasis with liver abscess. Post-operation, she required prolonged ventilation, with gradual weaning of oxygen. Imaging studies showed absence of left pectoralis major, thus a diagnosis of Poland syndrome. Gradually she was weaned off and had a successful post operative recovery.

Poland syndrome is a rare congenital abnormality. In patients undergoing general anaesthesia, the normal mechanics of breathing while ventilated are absent. Their recovery is longer and requires prolonged ICU admission.

We would like to thank Intensive Care Unit, Hospital Universiti Sains Malaysia for helping us in managing this case and provide the past medical history for this patient. We also would like to express our appreciation to Record Unit Office for allowing us to trace the old notes for this patient.
The case report was conducted without any sponsorship or monetary fund
No conflict of interest.
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