Abstract
Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.
| Original language | English |
|---|---|
| Pages (from-to) | 108-111 |
| Number of pages | 4 |
| Journal | Journal of Anesthesia |
| Volume | 25 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2011 |
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Keywords
- Diabetes insipidus
- Living donor liver transplantation
- Pituitary apoplexy
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation. / Matsusaki, Takashi; Morimatsu, Hiroshi; Matsumi, Junya; Matsuda, Hiroaki; Sato, Tetsufumi; Sato, Kenji; Mizobuchi, Satoshi; Yagi, Takahito; Morita, Kiyoshi.
In: Journal of Anesthesia, Vol. 25, No. 1, 02.2011, p. 108-111.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation
AU - Matsusaki, Takashi
AU - Morimatsu, Hiroshi
AU - Matsumi, Junya
AU - Matsuda, Hiroaki
AU - Sato, Tetsufumi
AU - Sato, Kenji
AU - Mizobuchi, Satoshi
AU - Yagi, Takahito
AU - Morita, Kiyoshi
PY - 2011/2
Y1 - 2011/2
N2 - Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.
AB - Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.
KW - Diabetes insipidus
KW - Living donor liver transplantation
KW - Pituitary apoplexy
UR - http://www.scopus.com/inward/record.url?scp=79952242421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952242421&partnerID=8YFLogxK
U2 - 10.1007/s00540-010-1070-7
DO - 10.1007/s00540-010-1070-7
M3 - Article
C2 - 21210157
AN - SCOPUS:79952242421
VL - 25
SP - 108
EP - 111
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
IS - 1
ER -