Related Experiment Video
Updated: Jul 14, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Diabetes insipidus as a complication after pituitary surgery
Jennifer A Loh1, Joseph G Verbalis
1Georgetown University-Washington Hospital Center Endocrinology and Metabolism Training Program, Washington, DC, USA.
Nature Clinical Practice. Endocrinology & Metabolism
|May 23, 2007
Summary
A sellar mass resection led to temporary, triphasic postoperative diabetes insipidus. This condition required careful monitoring and desmopressin (hormone therapy) for management.
Area of Science:
- Neuroendocrinology
- Neurosurgery
- Endocrinology
Background:
- A 28-year-old woman presented with vertigo and diplopia, revealing a sellar mass on MRI.
- Pituitary function tests indicated central hypothyroidism and secondary adrenal insufficiency.
Observation:
- Post-transsphenoidal resection, the patient developed acute polyuria, hypernatremia, and hypo-osmolality.
- These symptoms indicated a diagnosis of postoperative diabetes insipidus with a distinct triphasic pattern.
Findings:
- The patient experienced three distinct phases of diabetes insipidus, characterized by fluctuating antidiuretic responses.
- Initial treatment involved intravenous desmopressin, followed by fluid restriction during the antidiuretic phase, and ultimately chronic intranasal desmopressin therapy.
Implications:
- This case highlights the potential for triphasic diabetes insipidus following sellar mass resection.
- Effective management requires careful monitoring of fluid balance and osmolality, with tailored desmopressin therapy.
Related Concept Videos
01:29Diabetes Insipidus I: Introduction
Definition Diabetes insipidus is a disorder marked by the production of large amounts of dilute urine because of impaired vasopressin production, release, or kidney response. The lack of effective vasopressin action limits water reabsorption in the renal collecting ducts, which leads to excessive urinary water loss and intense thirst.Clinical PresentationIndividuals with diabetes insipidus report persistent thirst and very high urine output. In severe cases, fluid intake can reach up to 20...
01:22Diabetes Insipidus II: Pathophysiology
Normally, water balance is maintained through three interconnected mechanisms: the hypothalamic thirst center, the synthesis and release of antidiuretic hormone (ADH, or vasopressin), and the kidneys' responsiveness to this hormone. ADH is synthesized in the hypothalamus, released from the posterior pituitary, and acts on the distal nephron, allowing water reabsorption and concentrated urine production.Diabetes Insipidus and Its TypesIn diabetes insipidus (DI), this regulatory system is...
01:22Complications of Diabetes Mellitus
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:27Diabetic Retinopathy
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...