Acute adrenal crisis after orthopedic surgery for pathologic fractureReport as inadecuate




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World Journal of Surgical Oncology

, 5:27

First Online: 06 March 2007Received: 29 December 2006Accepted: 06 March 2007

Abstract

BackgroundAdrenal crisis after surgical procedure is a rare but potentially catastrophic life-threatening event. Its manifestations, such as hypotension, tachycardia, hypoxia, and fever mimic the other more common postoperative complications. Clinical outcome is dependent upon early recognition of the condition and proper management with exogenous steroid administration.

Case presentationWe report a 75-year-old man who presented with shock immediately after surgery for a femoral fracture from lung cancer metastasis. Anemia and severe hyponatremia were detected. Despite adequate fluid resuscitation, nonspecific symptoms including hypotension, tachycardia, hypoxia, fever and confusion occurred. Emergent CT revealed enlarged bilateral adrenal glands. Under the diagnosis of adrenal crisis due to metastatic infiltration of adrenal glands, the patient was treated with appropriate steroid replacement resulting in rapid improvement and recovery.

ConclusionWe describe a case of adrenal crisis caused by the lack of adrenal reserve based on metastatic involvement and surgical stress, the first published case of adrenal crisis after surgery for a pathologic fracture from lung cancer metastasis. Surgeons treating pathologic fractures should be aware of this complication and familiar with its appropriate therapy because of increasing opportunity to care patients with metastatic bone tumors due to recent advances in cancer treatment.

List of Abbreviations usedcomputed tomographyCT

magnetic resonance imagingMRI.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-5-27 contains supplementary material, which is available to authorized users.

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Author: Norifumi Naka - Satoshi Takenaka - Katsuhiko Nanno - Yu Moriguchi - Bang-mi Chun - Shunji Sonoda - Nobuyuki Hashimoto - Yos

Source: https://link.springer.com/







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