Zhao Nan, Gao Yutong, Ni Chunsheng, Zhang Danfang, Zhao Xiulan, Li Yanlei, Sun Baocun
Department of Pathology, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, PR China.
Department of Pathology, General Hospital of Tianjin Medical University, Tianjin, 300052, China.
Eur J Med Res. 2021 Dec 4;26(1):137. doi: 10.1186/s40001-021-00611-w.
Adrenal tuberculosis is difficult to diagnose due to non-specific symptom. Unexpected death due to adrenal insufficiency after trauma surgery is rare.
A 45-year-old man, who was admitted to hospital because of trauma to the right hand, died unexpectedly on the 13th day after replantation of amputated fingers. He was diagnosed with brain edema and diluted hyponatremia. Autopsy and histopathologic examination revealed severe brain edema combined with cerebellar tonsillar hernia, extensive destruction of adrenal gland caused by bilateral adrenal tuberculosis and right lung invasive pulmonary tuberculosis.
Trauma and pulmonary tuberculosis complicated with adrenal tuberculosis induced the adrenal crisis, which eventually lead to severe cerebral edema and hernia, and finally death from respiratory and circulatory failure. This autopsy and histopathologic examination suggested a possible pathophysiologic mechanism of sudden death due to diluted hyponatremia after trauma surgery.
肾上腺结核因症状不具特异性而难以诊断。创伤手术后因肾上腺功能不全导致的意外死亡较为罕见。
一名45岁男性因右手创伤入院，在断指再植术后第13天意外死亡。他被诊断为脑水肿和稀释性低钠血症。尸检及组织病理学检查显示，严重脑水肿合并小脑扁桃体疝，双侧肾上腺结核导致肾上腺广泛破坏，右肺为浸润性肺结核。
创伤及肺结核合并肾上腺结核引发肾上腺危象，最终导致严重脑水肿和脑疝，最终因呼吸和循环衰竭死亡。此次尸检及组织病理学检查提示了创伤手术后因稀释性低钠血症导致猝死的一种可能病理生理机制。
