alexa Anaesthetic Management of a Dwarf with Hypopituitarism Presenting for Epigastric Hernioplasty: A Case Report
ISSN: 2167-0943

Journal of Metabolic Syndrome
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Case Report

Anaesthetic Management of a Dwarf with Hypopituitarism Presenting for Epigastric Hernioplasty: A Case Report

Rajat Choudhuri, Sandeep Kr. Kar*, Dhiman Adhikari and Sabyasachi Sinha
Department of Anaesthesiology & Department of Cardiac Anaesthesiology, Institute of Post Graduate Medical Education &Research, Kolkata, India
Corresponding Author : Sandeep Kr. Kar
Department of Anaesthesiology & Department of Cardiac Anaesthesiology
Institute of Post Graduate Medical Education &Research
Kolkata, India
Tel: 22041101
E-mail: [email protected]
Received May 06, 2014; Accepted June 3, 2014; Published June 08, 2014
Citation: Choudhuri R, Sandeep KK, Adhikari D, Sinha S (2014) Anaesthetic Management of a Dwarf with Hypopituitarism Presenting for Epigastric Hernioplasty: A Case Report. J Metabolic Synd 3:154. doi:10.4172/2167-0943.1000154
Copyright: © 2014 Choudhuri R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Hypoplastic pituitary, a rare entity in itself and when presented to us requires a detailed evaluation and postoperative follow up. We are presenting a 48 year old lady who is short statured posted for epigastrichernioplasty. Detailed evaluation revealed secondary hypothyroidism, difficult airway, cardiomegaly, pericardial effusion, secondary adrenocortical insufficiency, growth hormone deficiency. CT scan of brain revealed cerebrospinal fluid filled sellar region and magnetic resonance imaging proved hypo plastic pituitary. After optimization with L-thyroxine she was planned for balanced general anaesthesia with epidural analgesia under steroid coverage. Peroperatively we faced resistant hypotension and due to inadequate reversal she was shifted to intensive care unit on ventilator. Subsequently we proved that her postoperative adrenocorticotropic hormone and cortisol level were low. However 24 hours later she could be extubated and finally she was discharged one week after the operation. However such cases are a challenge to the attending anaesthesiologist and as there is no strict protocol for anaesthetizing such a rare entity we have thought for detailing the case.

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