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Year : 2007  |  Volume : 10  |  Issue : 2  |  Page : 63-66

Anaesthesia in the undiagnosed thyrotoxic patient: A case report

Department of Anaesthesiology, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Nigeria

Correspondence Address:
C N Mato
Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, PMB 6173, Port Harcourt
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Source of Support: None, Conflict of Interest: None

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A 29-year old woman with a diagnosis of septicaemia, ruptured appendix and pelvic abscess was brought into theatre for emergency laparotomy. Pre-anaesthetic evaluation showed an emaciated ill-looking young woman with protuberant eyeballs. She was febrile, had marked tachycardia and a significantly raised blood pressure with a wide pulse pressure. There was no obvious or palpable anterior neck swelling, and a history of recent eye changes was denied. Time limited further investigations, so, with a high index of suspicion, emergency laparotomy was carried out under general anaesthesia with available hypotensive anaesthetic drugs. Thyroid function tests done post-operatively confirmed the suspicion of thyrotoxicosis, and she was commenced on oral carbimazole and propranolol. The case is presented, and the logistic problems of emergency anaesthesia in undiagnosed thyrotoxicosis are highlighted. It is emphasized that thyrotoxicosis should be considered in the differential diagnosis of significant tachycardia > 120min -1 in adults coming for anaesthesia.

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