From Pre-Existing Renal Failure to Perioperative Renal Protection: The Anesthesiologist's Dilemmas.

Context: Pre-existing renal dysfunction presents specific features that anesthesiologists must deal with. Anesthesia and renal function are connected and can interfere with each other. Induced hypotension anesthesia and the toxic effects of anesthetic drugs can further deteriorate renal function.

Anesthetic considerations on adrenal gland surgery.

Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues.

Anesthetic challenges of patients with cardiac comorbidities undergoing major urologic surgery.

The cardiac patient undergoing major urologic surgery is a complex case requiring a great attention by the anesthesiologist. Number of this group of patients having to go through this procedure is constantly increasing, due to prolonged life, increased agressiveness of surgery and increased anesthesia's safety. The anesthesiologist usually has to deal with several problems of the patient, such as hypertension, chronic heart failure, coronary artery disease, rhythm disturbances, intraoperative hemodymanic changes, intraoperative bleeding, perioperative fluid imbalance, and metabolic disturbances.

Acute right intrathoracic gastric volvulus. A rare surgical emergency.

The acute intrathoracic gastric volvulus is a rare condition, difficult to diagnose and treat. It consist in a abnormal organo-axial rotation over 180°, associated with gastric obstruction or strangulation. More uncommon condition is the gastric volvulus caused by a right sliding diaphragmatic hernia and dislocating the stomach, or part of it, on the right hemithorax.