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High scored thyroid storm after stomach cancer perforation: A case report
- Title
- High scored thyroid storm after stomach cancer perforation: A case report
- Authors
- Baik, Seung Min; Pae, Yejune; Lee, Jae-Myeong
- Ewha Authors
- 백승민
- SCOPUS Author ID
- 백승민
- Issue Date
- 2022
- Journal Title
- WORLD JOURNAL OF CLINICAL CASES
- ISSN
- 2307-8960
- Citation
- WORLD JOURNAL OF CLINICAL CASES vol. 10, no. 24, pp. 8768 - 8774
- Keywords
- Thyroid storm; Stomach cancer; Severity score; Sepsis; Case report
- Publisher
- BAISHIDENG PUBLISHING GROUP INC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- BACKGROUND Thyroid storm is a life-threatening emergency. Reportedly, the prevalence of thyroid storm is 1%-2% among patients admitted to the hospital for thyrotoxicosis. Burch and Wartofsky (1993) introduced a scoring system using precise clinical criteria to identify thyroid storms. Only 17 cases of thyroid storm with a score > 70 points have been reported. Although thyroid storms are uncommon, their clinical findings resemble those of sepsis. CASE SUMMARY A 48-year-old man was referred to the emergency room from a local clinic owing to suspicion of gastric ulcer perforation; medications for hypertension, diabetes mellitus, and hyperthyroidism had been suspended 1 year prior to this visit. We performed an emergency distal gastrectomy with Billroth II anastomosis for gastric cardia cancer perforation, and the patient was referred to the surgical intensive care unit (ICU). On the 2nd d in the ICU, his body temperature ( BT) increased to 41.3 degrees C at 19:00, with the thyroid storm score (90 points) peaking at 18:00 ( BT; 41.2 degrees C, pulse rate; 138/min, irritable status). The patient was administered propylthiouracil, intravenous glucocorticoids, acetaminophen, and Lugol's solution daily. Subsequently, we performed bladder irrigation with cold saline using a Foley catheter and applied a hypothermic blanket to decrease the patient's BT. His vital signs were stable on the 8th day in the ICU. CONCLUSION Thyroid storms are uncommon, with few reports in the literature; however, their clinical findings resemble those of sepsis and require further investigation. Since an untreated thyroid storm results in a high mortality rate, it should be investigated when managing sepsis.
- DOI
- 10.12998/wjcc.v10.i24.8768
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
- Files in This Item:
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