Postoperative myxedema coma in patients undergoing major surgery: Case series

Daniel Yafit, Narin Nard Carmel-Neiderman, Nadav Levy, Avrham Abergel, Alexander Niv, Ravit Yanko-Arzi, Arik Zaretski, Anat Wengier, Dan M. Fliss, Gilad Horowitz

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Myxedema coma is a serious complication of hypothyroidism that can be precipitated by major surgery. It is extremely rare, with only a few reports in the literature. This study aims to present a relatively large case series of post-surgical myxedema coma and to analyze medical and surgical risk factors. Methods: Analysis of the patients’ surgical records and medical charts. Results: Four patients developed postoperative myxedema coma and were evaluated for risk factors. Three had known hypothyroidism. Two had undergone large head and neck composite resections necessitating a free flap repair for malignant disease. One had undergone coronary artery bypass graft for ischemic heart disease, and another had undergone endoscopic cholecystectomy for complicated cholecystitis. All four patients required prolonged hospitalization, including treatment in the intensive care unit. One patient had undergone full cardiopulmonary resuscitation directly related to the myxedema coma state. Conclusion: We present a series of four patients who developed myxedema coma following major surgery. We recommend that patients with known hypothyroidism who are scheduled for major surgery should be tested for thyroid function status and assessed for postoperative risk of hypothyroidism. Those who develop complications following major surgery, should be immediately tested for thyroid function to rule out myxedema coma.

Original languageEnglish
Pages (from-to)605-608
Number of pages4
JournalAuris Nasus Larynx
Volume46
Issue number4
DOIs
StatePublished - 1 Aug 2019
Externally publishedYes

Keywords

  • Hypothyroidism
  • ICU
  • Major surgery
  • Myxedema coma

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