Shock-Related Thyroid Changes: A Rare Presentation in a Young Patient With Hemorrhagic Shock Secondary to a Road...

Shock-related thyroid changes are a rare radiological finding, considered part of the hypovolemic shock complex. It is characterized by thyroidal and perithyroidal edema without direct thyroid injury, typically seen in severe trauma. Very few cases have been described in the literature. We report a case of a 15-year-old male who presented in hemorrhagic shock following a road traffic accident. Whole-body computed tomography (CT) imaging demonstrated heterogeneous thyroid enhancement with perithyroidal edema, consistent with shock-related thyroid changes, in the absence of direct thyroid trauma. The patient also sustained a high-grade splenic injury requiring emergent laparotomy and splenectomy, along with orthopedic intervention for a femur fracture. Thyroid function tests were normal, and the patient gradually improved with appropriate surgical and supportive management. The radiological features of shock-related thyroid changes are distinct and must be differentiated from direct thyroid injury or adjacent vascular damage. The underlying pathophysiology is uncertain, but proposed mechanisms include third-spacing of resuscitative fluids or thyroidal hypoperfusion during profound hypovolemia. Recognition of this entity is crucial as it is self-limiting and does not require specific thyroid-directed intervention. Shock-related thyroid changes are a rare but important secondary imaging finding in the setting of severe trauma and hypovolemic shock. Awareness of this condition can help avoid misdiagnosis and unnecessary investigations.