期刊论文详细信息
BMC Endocrine Disorders
A challenging case of Cushing’s disease complicated with multiple thrombotic phenomena following trans-sphenoidal surgery; a case report
Piyumi Sachindra Alwis Wijewickrama1  Sathyajith Buddhika Ambawatte1  Vithiya Ratnasamy1  Noel P. Somasundaram2  Manilka Sumanatilleke2 
[1] Ministry of Health, Colombo, Sri Lanka;National Hospital of Sri Lanka, Colombo, Sri Lanka;
关键词: Cushing’s disease;    Thrombosis;    Stroke;    Diverticular rupture;    Case report;   
DOI  :  10.1186/s12902-021-00701-0
来源: Springer
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【 摘 要 】

BackgroundCushing’s syndrome occurs due to overproduction of cortisol from adrenal glands. Endogenous hypercortisolemia can occur secondary to adrenocorticotropic hormone (ACTH) dependent as well as independent causes. The presence of non-specific symptoms and signs contributes to a delay in diagnosis. Early identification and prompt definitive management is crucial. It is important to be alert about the post-operative complications including multiple thrombotic phenomena, which can add to the mortality. We report a case of Cushing’s disease in a young female managed with trans-sphenoidal surgery, followed by a challenging post-operative period complicated with multiple thrombotic phenomena, ultimately succumbed.Case presentationA 32-year-old Sri Lankan female presented with overt features of Cushing’s syndrome and diagnosed to have ACTH dependent Cushing’s disease with pituitary microadenoma. She underwent trans-sphenoidal surgery, following which she developed fatal multiple complications including diverticular rupture and ischemic colitis, needing hemicolectomy, followed by a parieto-occipital infarction.ConclusionThis case highlights important and aggressive complications associated with Cushing’s syndrome giving rise to a challenging post-operative course. Diverticular rupture had been described in association with hypercortisolemia and this case adds to the existing literature. Post-operative ischemic colitis and stroke which contributed to the death of this patient could have been due to the procoagulant state associated with Cushing’s syndrome, with a high risk during the immediate post-operative period. This emphasizes the need to consider post-operative thromboprophylaxis in patients undergoing surgery for Cushing’s syndrome.

【 授权许可】

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