Westmead Hospital

  • 20-year-old male, scheduled for a left hemicolectomy, with a background including congenital myopathy with severe neuromuscular weakness and restrictive lung disease, ventilator dependence and permanent tracheostomy and frequent hospital admissions for recurrent chest infections. Clinical findings included kyphoscoliosis, wasting and weakness of all muscles with preserved sensation, signs of restrictive lung disease and the presence of a tracheostomy and a PEG. Candidates were asked to identify the key issues for his peri- operative management. Other discussion points included interpretation of investigations and imaging and aspects of his chronic co-morbidities.