Mohseni Michael M, Graham Charles
Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida.
Proc (Bayl Univ Med Cent). 2021 Apr 20;34(4):484-485. doi: 10.1080/08998280.2021.1906829.
We report a case of thyroid storm with concomitant acute appendicitis. The patient had clinical findings concerning for an acute abdomen. However, this physical examination finding can occur in some individuals presenting with severe thyrotoxicosis or thyroid storm without an underlying surgical process. In this case, the patient received aggressive treatment perioperatively for her thyroid storm and required continued treatment for her thyroid state after appendectomy. Differentiating medical vs surgical causes for an acute abdomen while simultaneously recognizing the thyrotoxic state is imperative in such a scenario. Clinicians must proceed cautiously to optimize patients' thyroid status before any operative interventions to minimize risks of cardiovascular collapse or death.
我们报告一例伴有急性阑尾炎的甲状腺危象病例。该患者有提示急腹症的临床表现。然而,这种体格检查发现也可能出现在一些患有严重甲状腺毒症或甲状腺危象而无潜在外科疾病的个体中。在本病例中,患者围手术期针对甲状腺危象接受了积极治疗,阑尾切除术后仍需继续治疗甲状腺状态。在这种情况下,区分急腹症的内科病因与外科病因,同时识别甲状腺毒症状态至关重要。临床医生在进行任何手术干预之前必须谨慎行事,以优化患者的甲状腺状态,从而将心血管虚脱或死亡的风险降至最低。