Karamchandani Kunal, Leathem Jarrett, Sinz Elizabeth H
From the Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.
A A Pract. 2019 Feb 1;12(3):63-65. doi: 10.1213/XAA.0000000000000846.
Acute adrenal insufficiency is a rare but potentially life-threatening event during the perioperative period. The usual manifestations of an acute adrenal crisis can mimic common postoperative complications and a high index of suspicion is required for the diagnosis. Early diagnosis and prompt treatment can be lifesaving. We present the case of a 65-year-old man who, after a partial nephrectomy, developed acute adrenal insufficiency, which remained undiagnosed in the postoperative period, eventually leading to cardiac arrest. This case highlights the need for perioperative physicians to have a watchful eye for diagnosing and treating this uncommon yet lethal condition.
急性肾上腺功能不全是围手术期罕见但可能危及生命的事件。急性肾上腺危象的常见表现可类似于常见的术后并发症,诊断时需要高度怀疑。早期诊断和及时治疗可挽救生命。我们报告一例65岁男性患者,在接受部分肾切除术后发生急性肾上腺功能不全,术后未被诊断出来,最终导致心脏骤停。该病例凸显了围手术期医生在诊断和治疗这种罕见但致命疾病时需要密切关注。