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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Immediate post-parathyroidectomy stridor resolved with intravenous calcium.
Simon Adams1, Alexander Harold, William Bremner
1University Hospital of North Durham, Department of General Surgery, North Road, Durham DH1 5TW, UK.
BMJ Case Reports
|June 21, 2011
Summary
Post-parathyroidectomy respiratory distress in a patient was successfully treated with intravenous calcium. This case highlights calcium
Area of Science:
- Endocrinology
- Anesthesiology
- Otolaryngology
Background:
- Parathyroidectomy is a common surgical procedure for parathyroid adenoma.
- Post-operative airway complications can occur, necessitating prompt diagnosis and management.
- Hypocalcemia is a known complication of parathyroid surgery, but its role in immediate post-extubation stridor is less understood.
Purpose of the Study:
- To report a case of post-parathyroidectomy stridor.
- To investigate the potential role of transient hypocalcemia in this complication.
- To highlight the efficacy of calcium administration in managing such cases.
Main Methods:
- Case report of a 73-year-old woman undergoing focused parathyroidectomy.
- Clinical observation of immediate post-extubation respiratory distress and stridor.
- Therapeutic trial with nebulized adrenaline and intravenous calcium administration.
Main Results:
- The patient developed severe stridor and respiratory distress immediately after extubation.
- Nebulized adrenaline was ineffective; intravenous calcium bolus provided temporary relief.
- Sustained improvement was achieved with an intravenous calcium infusion, despite initially normal serum calcium levels.
Conclusions:
- Transient hypocalcemia, even within normal serum ranges, may precipitate airway compromise post-parathyroidectomy.
- Intravenous calcium administration is an effective treatment for post-parathyroidectomy stridor potentially related to hypocalcemia.
- This case underscores the importance of considering biochemical imbalances in the differential diagnosis of post-operative airway issues.
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