Article Outline

Pancreatic Surgery

Preoperative Considerations

Intraoperative Considerations

Postoperative Considerations

Parathyroid Surgery

Preoperative Considerations - Chronic kidney disease, Adenoma versus hyperplasia, Pretreatment with calcitriol (prevent hypocalcemia), Pretreatment with bisphosphonate (prevent “hungry bone syndrome”)

Urolithiasis and Urinary Tract Infections

Postoperative Considerations - Persistent or recurrent hypercalcemia; Management of hypocalcemia: acute and subacute / chronic

Adrenal Surgery

Adrenal-dependent hyperadrenocorticism

Pheochromocytoma

Preoperative Considerations 

Arrhythmias and Hypertension

Risks of Surgery - Hemorrhage; Caval invasion (tumor, thrombi); Thromboembolism

Postoperative Considerations - Thromboembolism; Hypoadrenocorticism
 

Summary

References

KEY POINTS

Diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome, hypoglycemia, insulinoma, hypoadrenocorticism, pheochromocytoma, thyrotoxicosis, and myxedema coma are all examples of life-threatening complications of endocrine disease.

Success in treatment of endocrine emergencies is contingent on early recognition and treatment.

Many endocrine diseases presenting emergently have nonspecific signs and symptoms.  Endocrine crises are often precipitated by concurrent disease, further making early identification difficult.

Article Outline

• Diabetic ketoacidosis
• • Pathophysiology
  • • Carbohydrate Metabolism
    • Lipid Metabolism
    • Fluid and Electrolyte Metabolism
    • Acid-Base Changes
  • Treatment
  • • Fluid Therapy
    • Fluid Composition
    • Rate and Volume of Fluid Administration
    • Insulin Therapy
    • Potassium Supplementation
    • Phosphorus Supplementation
    • Magnesium Supplementation
    • Bicarbonate Administration
• Hyperglycemic hyperosmolar state
• • Treatment
• Hypoadrenocorticism
• • Pathophysiology
  • Clinical findings
  • Diagnosis
  • Treatment
  • • Fluid Therapy
    • Fluid Composition
    • Rate and Volume of Fluid Administration
    • Glucocorticoid Replacement
    • Mineralocorticoid Replacement
    • Management of Hyperkalemia
    • Management of Metabolic Acidosis
• Hypoglycemia
• Myxedema stupor and coma
• Heatstroke
• • Pathophysiology
  • Treatment
• References