The spectrum of emergency admissions for thyroidectomy

Emergency physicians frequently encounter patients with thyroid disease. However, it is unusual for these thyroid disorders to create acute, life-threatening situations. Critical airway compression attributable to benign or malignant thyroid enlargement may occur suddenly. Similarly, venous obstruction from thyroid tumors or severe physiological compromise from thyrotoxicosis may require urgent treatment. We reviewed a group of patients who were evaluated by emergency physicians for acute thyroid pathology and subsequently admitted for urgent thyroidectomy. Over a 7-year period, 13 patients had acute airway compressive symptoms, and 1 had acute venous compressive symptoms. Six patients had thyrotoxicosis with physiological compromise. Common airway management techniques were successfully used. Nineteen patients underwent thyroidectomy. One patient suffered a cardiopulmonary arrest before thyroidectomy could be performed. Surgical morbidity may be increased for patients undergoing thyroidectomy for urgent indications.