Successful treatment of thyrotoxic crisis after esophagectomy in an elderly woman with hyperthyroidism

Ann Thorac Surg. 2012 Jun;93(6):e141-2. doi: 10.1016/j.athoracsur.2011.12.042.

Abstract

We describe herein a case of thyrotoxic crisis after esophagectomy in a 64-year-old woman with esophageal carcinoma and well-controlled hyperthyroidism. On the fourth postoperative day, she had palpitations, abdominal pain, fever, and tachycardia, which were similar to the symptoms of an anastomotic leak. There was no evidence to indicate the existence of an anastomotic leak after examination. We were confused at first. After turning to Burch and Wartofsky's scoring system, we finally diagnosed thyrotoxic crisis and then prescribed several agents for emergency treatment, including propylthiouracil, metoprolol tartrate, and hydrocortisone. Afterward, she recovered and was discharged safely.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-1 Receptor Antagonists / administration & dosage*
  • Anastomotic Leak / diagnosis
  • Anti-Inflammatory Agents / administration & dosage*
  • Antithyroid Agents / administration & dosage*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy*
  • Female
  • Humans
  • Hydrocortisone / administration & dosage*
  • Hyperthyroidism / complications*
  • Hyperthyroidism / diagnosis
  • Metoprolol / administration & dosage*
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy*
  • Propylthiouracil / administration & dosage*
  • Thyroid Crisis / diagnosis
  • Thyroid Crisis / drug therapy*

Substances

  • Adrenergic beta-1 Receptor Antagonists
  • Anti-Inflammatory Agents
  • Antithyroid Agents
  • Propylthiouracil
  • Metoprolol
  • Hydrocortisone