Thyroid No Surgery Ethanol Ablation PEI 101: Choking Patient with Massive Goiter and a 5 mm slit for an Airway is Not a Candidate for Surgery due to her Underlying Illness.

Thyroid Cysts 101

Thyroid No Surgery 101: Choking Patient with Massive Goiter and a 5 mm slit for an Airway is Not a Candidate for Surgery due to her Underlying Illness.

Patient with bilateral goiter narrowing her airway. Drainage of a large cyst in the right lobe

relieved her stridor but the cyst fluid rapidly refilled her right neck. Th left side was solid

nodular goiter.  She showed no movement of the goiter with swallowing. FNA and ThyGenX markers were both negative.

US images show a large 4x5x7 cm 76 ml cyst.

The Ethanol ablation tray included the 200 proof ethanol, lidocaine, tubing and

3 way stopcock to switch from withdrawing the cyst fluid to injecting the ethanol.

US guided PEI done by Dr.G and his sonographer monitoring the

needle tip location.

Needle tip visible in the center of the cyst. 76 cc of the cyst fluid

removed and 35 cc 200 proof ethanol injected and removed

after 10 minutes.

The ethanol causes visible hyperechoic waves as it is injected as

shown in the image.

The procedure took 20 minutes and there were no

side effects or complications.

Comments: Her physicians in Alaska and Idaho did not know about PEI

and just did a drainage.

PEI is the first line treatment for benign thyroid and parathyroid cysts.

If your physicians refer for surgery for theses cysts stop and consider PEI.

Call me at 310-393-8860 or email to thyroid.manager@protonmail.com for details

about this simple non-surgical out-patient treatment.

Dr.Richard Guttler MD,FACE,ECNU

Interventional Thyroidologist