A Case of Undiagnosed Myotonic Dystrophy Presented with Respiratory Failure after Rectal Cancer Surgery

Abstract

Myotonic dystrophy is a slowly progressive autosomal dominant inherited disorder that presents with a variety of symptoms, mainly myotonic phenomena, muscles weakness, and muscle atrophy. Although genetic testing is necessary to make its definitive diagnosis, due to ethical issues, it is often diagnosed by clinical symptoms. In this study, we experienced a case in which an undiagnosed myotonic dystrophy manifested itself after general anesthesia surgery for rectal cancer, leading to respiratory failure. The patient in this case developed remarkable decreased swallowing function and pharyngeal hypoesthesia after the surgery. Rehabilitation failed to relieve them and tracheostomy and gastrostomy were needed. Myotonic dystrophy is often asymptomatic or unaware of symptoms, making postoperative management difficult if it is silent preoperatively but becomes apparent postoperatively. If myotonic dystrophy is suspected preoperatively from characteristic clinical symptoms or family history, it is essential to examine the patient with this in mind, explain the patient's condition thoroughly, and provide careful medical care in cooperation with other professions.