Recognition of adrenal insufficiency in the postoperative patient

The signs and symptoms of adrenal insufficiency in the postoperative patient are generally nonspecific, and the diagnosis is usually made at postmortem examination. Two patients in whom adrenal insufficiency developed in the postoperative period are reported on (one had metastatic carcinoma to the adrenal glands and in the other bilateral adrenal hemorrhage developed during anticoagulant treatment). Both patients survived multiple, successive stressful episodes before the diagnosis of adrenal insufficiency was established by the alpha1-24 corticotropin stimulation test.