World Journal of Clinical Cases
ISSN 2307-8960 (online)
World J Clin Cases 2022 August 26; 10(24): 8432-8807
Published by Baishideng Publishing Group Inc
WJCC https://www.wjgnet.com I August 26, 2022 Volume 10 Issue 24
World Journal of Clinical Cases
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Contents Thrice Monthly Volume 10 Number 24 August 26, 2022
EDITORIAL
Evolution of World Journal of Clinical Cases over the past 5 years 8432
Muthu S
OPINION REVIEW
NF-κB: A novel therapeutic pathway for gastroesophageal reflux disease?
8436
Zhang ML, Ran LQ, Wu MJ, Jia QC, Qin ZM, Peng YG
MINIREVIEWS
Obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli, Tsukamurella tyrosinosolvens: Minireview of a rare opportunistic pathogen
8443
Usuda D, Tanaka R, Suzuki M, Shimozawa S, Takano H, Hotchi Y, Tokunaga S, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Oba J, Nomura T, Sugita M
Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects
8450
Safri AA, Nassir CMNCM, Iman IN, Mohd Taib NH, Achuthan A, Mustapha M
Graft choices for anterolateral ligament knee reconstruction surgery: Current concepts 8463
Chalidis B, Pitsilos C, Kitridis D, Givissis P
Overview of the anterolateral complex of the knee 8474
Garcia-Mansilla I, Zicaro JP, Martinez EF, Astoul J, Yacuzzi C, Costa-Paz M
Complication of lengthening and the role of post-operative care, physical and psychological rehabilitation among fibula hemimelia
8482
Salimi M, Sarallah R, Javanshir S, Mirghaderi SP, Salimi A, Khanzadeh S
ORIGINAL ARTICLE
Clinical and Translational Research
Pyroptosis-related genes play a significant role in the prognosis of gastric cancer 8490
Guan SH, Wang XY, Shang P, Du QC, Li MZ, Xing X, Yan B
Retrospective Study
Effects of propofol combined with lidocaine on hemodynamics, serum adrenocorticotropic hormone, interleukin-6, and cortisol in children
8506
Shi S, Gan L, Jin CN, Liu RF
Correlation analysis of national elite Chinese male table tennis players’ shoulder proprioception and muscle strength
8514
Shang XD, Zhang EM, Chen ZL, Zhang L, Qian JH
WJCC https://www.wjgnet.com II August 26, 2022 Volume 10 Issue 24
World Journal of Clinical Cases
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Thrice Monthly Volume 10 Number 24 August 26, 2022
Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)
8525
Mei Q, Yu M, Chen Q
Identification of predictive factors for post-transarterial chemoembolization liver failure in hepatocellular carcinoma patients: A retrospective study
8535
Yuan M, Chen TY, Chen XR, Lu YF, Shi J, Zhang WS, Ye C, Tang BZ, Yang ZG
Clinical significance of half-hepatic blood flow occlusion technology in patients with hepatocellular carcinoma with cirrhosis
8547
Liu D, Fang JM, Chen XQ
Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study
8556
D'Acapito F, Solaini L, Di Pietrantonio D, Tauceri F, Mirarchi MT, Antelmi E, Flamini F, Amato A, Framarini M, Ercolani G
Clinical Trials Study
Computed tomography combined with gastroscopy for assessment of pancreatic segmental portal hypertension
8568
Wang YL, Zhang HW, Lin F
Observational Study
Psychological needs of parents of children with complicated congenital heart disease after admitting to pediatric intensive care unit: A questionnaire study
8578
Zhu JH, Jin CD, Tang XM
Prospective Study
Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion- weighted imaging
8587
Zhu X, Wang J, Wang YC, Zhu ZF, Tang J, Wen XW, Fang Y, Han J
Randomized Controlled Trial
Application of unified protocol as a transdiagnostic treatment for emotional disorders during COVID-19:
An internet-delivered randomized controlled trial 8599
Yan K, Yusufi MH, Nazari N
High-flow nasal cannula oxygen therapy during anesthesia recovery for older orthopedic surgery patients:
A prospective randomized controlled trial 8615
Li XN, Zhou CC, Lin ZQ, Jia B, Li XY, Zhao GF, Ye F
SYSTEMATIC REVIEWS
Assessment tools for differential diagnosis of neglect: Focusing on egocentric neglect and allocentric neglect
8625
Lee SH, Lim BC, Jeong CY, Kim JH, Jang WH
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World Journal of Clinical Cases
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Thrice Monthly Volume 10 Number 24 August 26, 2022
CASE REPORT
Exome analysis for Cronkhite-Canada syndrome: A case report 8634
Li ZD, Rong L, He YJ, Ji YZ, Li X, Song FZ, Li XA
Discrepancy between non-invasive prenatal testing result and fetal karyotype caused by rare confined placental mosaicism: A case report
8641
Li Z, Lai GR
Paroxysmal speech disorder as the initial symptom in a young adult with anti-N-methyl-D-aspartate receptor encephalitis: A case report
8648
Hu CC, Pan XL, Zhang MX, Chen HF
Anesthetics management of a renal angiomyolipoma using pulse pressure variation and non-invasive cardiac output monitoring: A case report
8656
Jeon WJ, Shin WJ, Yoon YJ, Park CW, Shim JH, Cho SY Traumatic giant cell tumor of rib: A case report 8662
Chen YS, Kao HW, Huang HY, Huang TW
Analysis of two naval pilots’ ejection injuries: Two case reports 8667
Zeng J, Liu XP, Yi JC, Lu X, Liu DD, Jiang YQ, Liu YB, Tian JQ
Beware of the DeBakey type I aortic dissection hidden by ischemic stroke: Two case reports 8673
Chen SQ, Luo WL, Liu W, Wang LZ
Unilateral lichen planus with Blaschko line distribution: A case report 8679
Dong S, Zhu WJ, Xu M, Zhao XQ, Mou Y
Clinical features and progress of ischemic gastritis with high fatalities: Seven case reports 8686
Shionoya K, Sasaki A, Moriya H, Kimura K, Nishino T, Kubota J, Sumida C, Tasaki J, Ichita C, Makazu M, Masuda S, Koizumi K, Kawachi J, Tsukiyama T, Kako M
Retinoblastoma in an older child with secondary glaucoma as the first clinical presenting symptom: A case report
8695
Zhang Y, Tang L
Recurrent herpes zoster in a rheumatoid arthritis patient treated with tofacitinib: A case report and review of the literature
8703
Lin QX, Meng HJ, Pang YY, Qu Y
Intra-abdominal ectopic bronchogenic cyst with a mucinous neoplasm harboring a GNAS mutation: A case report
8709
Murakami T, Shimizu H, Yamazaki K, Nojima H, Usui A, Kosugi C, Shuto K, Obi S, Sato T, Yamazaki M, Koda K
Effects of intravascular photobiomodulation on motor deficits and brain perfusion images in intractable myasthenia gravis: A case report
8718
Lan CH, Wu YC, Chiang CC, Chang ST
WJCC https://www.wjgnet.com IX August 26, 2022 Volume 10 Issue 24
World Journal of Clinical Cases
Contents
Thrice Monthly Volume 10 Number 24 August 26, 2022
Spontaneous acute epidural hematoma secondary to skull and dural metastasis of hepatocellular carcinoma: A case report
8728
Lv GZ, Li GC, Tang WT, Zhou D, Yang Y
Malignant melanotic nerve sheath tumors in the spinal canal of psammomatous and non-psammomatous type: Two case reports
8735
Yeom JA, Song YS, Lee IS, Han IH, Choi KU
When should endovascular gastrointestinal anastomosis transection Glissonean pedicle not be used in hepatectomy? A case report
8742
Zhao J, Dang YL
VARS2 gene mutation leading to overall developmental delay in a child with epilepsy: A case report 8749
Wu XH, Lin SZ, Zhou YQ, Wang WQ, Li JY, Chen QD
Junctional bradycardia in a patient with COVID-19: A case report 8755
Aedh AI
Application of 3 dimension-printed injection-molded polyether ether ketone lunate prosthesis in the treatment of stage III Kienböck’s disease: A case report
8761
Yuan CS, Tang Y, Xie HQ, Liang TT, Li HT, Tang KL
High scored thyroid storm after stomach cancer perforation: A case report 8768
Baik SM, Pae Y, Lee JM
Cholecystitis-an uncommon complication following thoracic duct embolization for chylothorax: A case report
8775
Dung LV, Hien MM, Tra My TT, Luu DT, Linh LT, Duc NM
Endometrial squamous cell carcinoma originating from the cervix: A case report 8782
Shu XY, Dai Z, Zhang S, Yang HX, Bi H
Type 2 autoimmune pancreatitis associated with severe ulcerative colitis: Three case reports 8788
Ghali M, Bensted K, Williams DB, Ghaly S
Diffuse uterine leiomyomatosis: A case report and review of literature 8797
Ren HM, Wang QZ, Wang JN, Hong GJ, Zhou S, Zhu JY, Li SJ
LETTER TO THE EDITOR
Comment on “Posterior reversible encephalopathy syndrome in a patient with metastatic breast cancer: A case report”
8805
Kunić S, Ibrahimagić OĆ, Kojić B, Džananović D
WJCC https://www.wjgnet.com X August 26, 2022 Volume 10 Issue 24
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ABOUT COVER
Editorial Board Member of World Journal of Clinical Cases, Ahmed Mohamed Ahmed Al-Emam, PhD, Associate Professor, Department of Pathology, King Khalid University, Abha 62521, Saudi Arabia. [email protected]
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Submit a Manuscript: https://www.f6publishing.com World J Clin Cases 2022 August 26; 10(24): 8768-8774
DOI: 10.12998/wjcc.v10.i24.8768 ISSN 2307-8960 (online)
CASE REPORT
High scored thyroid storm after stomach cancer perforation: A case report
Seung Min Baik, Yejune Pae, Jae-Myeong Lee
Specialty type: Medicine, research and experimental
Provenance and peer review:
Unsolicited article; Externally peer reviewed.
Peer-review model: Single blind Peer-review report’s scientific quality classification
Grade A (Excellent): 0 Grade B (Very good): B Grade C (Good): C Grade D (Fair): D Grade E (Poor): E
P-Reviewer: Bains L, India; Chang YY, Taiwan; Kurniawati EM, Indonesia; Yang L, China Received: April 4, 2022
Peer-review started: April 4, 2022 First decision: June 16, 2022 Revised: June 20, 2022 Accepted: July 8, 2022 Article in press: July 8, 2022 Published online: August 26, 2022
Seung Min Baik, Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, South Korea
Seung Min Baik, Yejune Pae, Department of Surgery, College of Medicine, Graduate School of Korea University, Seoul 02841, South Korea
Jae-Myeong Lee, Department of Acute Care Surgery, Korea University Anam Hospital, Seoul 02841, South Korea
Corresponding author: Jae-Myeong Lee, PhD, Associate Professor, Department of Acute Care Surgery, Korea University Anam Hospital, Goryeodae-ro 73, Seongbuk-gu, Seoul 02841, South Korea. [email protected]
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 thyrotox- icosis. 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 °C at 19:00, with the thyroid storm score (90 points) peaking at 18:00 (BT; 41.2ºC, 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
Baik SM et al. High scored thyroid storm after stomach cancer perforation
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an untreated thyroid storm results in a high mortality rate, it should be investigated when managing sepsis.
Key Words: Thyroid storm; Stomach cancer; Severity score; Sepsis; Case report
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Core Tip: Since thyroid storm is a life-threatening emergency and mortality is high when treatment is delayed, thyroid function evaluation should not be overlooked when managing sepsis.
Citation: Baik SM, Pae Y, Lee JM. High scored thyroid storm after stomach cancer perforation: A case report.
World J Clin Cases 2022; 10(24): 8768-8774
URL: https://www.wjgnet.com/2307-8960/full/v10/i24/8768.htm DOI: https://dx.doi.org/10.12998/wjcc.v10.i24.8768
INTRODUCTION
Thyroid storm is a life-threatening emergency. Reportedly, the prevalence of thyroid storm 1%-2%
among patients admitted to the hospital for thyrotoxicosis[1]. In a nationwide survey of hospitals in Japan, the incidence of thyroid storm in hospitalized patients was 0.22% among all patients with thyrotoxicosis and 5.4% of patients admitted to the hospital for thyrotoxicosis[2,3]. Thyroid storm can develop in patients with long-standing untreated hyperthyroidism and can be precipitated by an acute event such as thyroid or non-thyroidal surgery, trauma, infection, an acute iodine load, or parturition[4].
Recent data suggest that the mortality rate of thyroid storms is approximately 10%-30%[1,2]. Multiple organ failure is the most common cause of death, followed by congestive heart failure, respiratory failure, arrhythmia, disseminated intravascular coagulation, gastrointestinal perforation, hypoxic brain syndrome, and sepsis[2,3].
Thyroid storm is diagnosed by clinical findings. Burch and Wartofsky (1993) introduced a scoring system using precise clinical criteria for the identification of thyroid storms[5]. Based on these criteria, a score of < 25 points indicates that a thyroid storm is unlikely; 25-44 points an impending thyroid storm;
and ≥ 45 points, thyroid storm. There is no concept of a “severe” thyroid storm. However, to the best of our knowledge, only 17 cases of thyroid storm with a score > 70 points have been reported. Among these 17 cases, only four cases had a score of 90 points. Although thyroid storms are uncommon, their clinical findings resemble those of sepsis.
Here, we report a case of thyroid storm with a score of 90 points after gastric perforation surgery, and we analyze the “severe” form of thyroid storm (with a score > 70 points) in the 17 cases reported in the literature.
CASE PRESENTATION
Chief complaints
In the emergency room (ER), he complained of nausea, diffuse abdominal pain, general weakness, anorexia, and indigestion, which had started 4 d prior to admission.
History of present illness
A 48-year-old male patient was referred to the ER from a local clinic owing to suspicion of gastric ulcer perforation. We performed an emergent distal gastrectomy with Billroth II anastomosis for gastric cardia cancer perforation, a palliative surgery performed owing to peritoneal tumor seeding. The total operating time was 3 h and 55 min, and the patient's vital signs were stable during surgery. Postoper- atively, the patient was referred to the surgical intensive care unit (ICU), and his vital signs were checked every hour.
History of past illness
He had a medical history of hypertension, type II diabetes mellitus (DM), and hyperthyroidism. One year ago, he had stopped taking medications for hypertension, DM, and hyperthyroidism.
Baik SM et al. High scored thyroid storm after stomach cancer perforation
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Personal and family history
The patient's personal and family history information could not be obtained.
Physical examination
On physical examination, he presented with hypoactive bowel sounds and direct tenderness in the epigastric area.
Laboratory examinations
Laboratory examination in the ER showed the following results: white blood cell counts 12.5 × 103/µL, erythrocyte sedimentation rate 38 mm/h, and C-reactive protein 16.93 mg/dL.
The results of thyroid function tests are shown in Table 1. The free T4, T3, and T4 Levels exceeded the normal range, while thyroid stimulating hormone levels were below the normal range. The other laboratory results were non-specific.
Imaging examinations
Computed tomography in the ER revealed peritonitis due to gastric ulcer perforation and gastric malignancy with suspected peritoneal carcinomatosis.
FINAL DIAGNOSIS
On the 2nd d in the ICU, the patient’s body temperature (BT) increased to 41.3 °C at 19:00, and the thyroid storm score peaked at 18:00 (BT 41.2 °C; pulse rate: 138/min); furthermore, he was irritable; had a Glasgow Coma Scale score of E3V1M5, with eye opening to speech, no verbal response, and localized motor response to pain; and complained of severe pain (Table 2). The patient's highest score for a thyroid storm was 90.
TREATMENT
The patient was administered a daily dose of oral propylthiouracil (PTU) 800 mg, PTU enema 400 mg, intravenous glucocorticoids 40 mg, oral acetaminophen 650 mg, and oral Lugol’s solution 1.5 mL.
Subsequently, we performed bladder irrigation with cold saline using a Foley catheter and applied a hypothermic blanket to decrease the patient's BT.
On the 3rd d in the ICU, the PTU dose was increased to 1200 mg/d, while the doses of the other drugs were maintained. From the 4th day, the oral PTU dose was fixed at 200 mg, q6hd; Lugol’s solution (0.5 mL; q8hd) was also delivered. On the 9th d, the patient was referred to the general ward, with the administration of oral PTU 200 mg four times daily and tapering of glucocorticoid therapy.
OUTCOME AND FOLLOW-UP
The patient’s vital signs were stable from the 8th postoperative day, and he showed clear mental status on the 4th postoperative day (Figure 1). In the general ward, on the 15th day, the oral PTU dose was decreased to 200 mg three times daily. On the 29th hospital day, he was discharged with an asymptomatic status, stable vital signs, and a prescribed dose of oral PTU 200 mg three times daily.
DISCUSSION
We report a case of thyroid storm with extremely high fever (41.3 °C), typically associated with patient mortality. Indeed, high fever alone increases mortality in ICU patients[6].
While this patient’s BT was < 40 °C in the ER, it increased to > 40ºC postoperatively. Later, the patient presented with tachycardia (peaked at 138/min), irritability, and abdominal pain; he also had a history of hyperthyroidism, with a high score of 90 points in the thyroid storm scoring system, which reflects disease severity. Based on the scoring system, thyroid storms are considered unlikely for scores of < 25 points, while 25-45 points suggest impending storms; a score of > 45 points is highly associated with thyroid storms[5] (Table 2). Therefore, when the score approaches 45 points, the patient needs more intensive monitoring and re-evaluation for thyroid storm. The mortality risk associated with thyroid storm is estimated to be 8%-25%, despite modern advancements in treatment and supportive measures [7].
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Table 1 Thyroid function test values of the patient
Hormone (normal range, unit) At ER (preoperation) Postop. day 6 Postop. day 11
T3 (60.0-181.0, ng/dL) 625.4 79.9 94.1
T4 (4.50-10.90, ng/dL) 27.27 5.80 12.45
fT4 (0.89-1.76, ng/dL) 7.02 1.90 3.58
TSH (0.55-4.78, uIU/mL) < 0.008 < 0.008 < 0.008
ER: Emergency room; Postop.: Postoperative; TSH: Thyroid stimulating hormone.
Table 2 Summary severity scores of previously reported thyroid storm cases over 70 points and the present case
Case No. Age/Gender BT CNS effect GI-hepatic
dysfx. CV dysfx. HF Pre. Hx. Total Mortality Ref.
1 40/Male 20 30 20 35 10 0 115 No Shimoda et al[8], 2014
2 50/Female 0 20 0 35 5 10 90 No Izumi et al[9], 2009
3 48/Male 10 10 20 25 10 10 85 No Sasaki et al[10], 2011
4 30/Female 15 30 0 25 0 10 80 Yes Yamaji et al[11], 1991
5 43/Male 10 20 10 25 5 10 80 No Diaz et al[12], 2009
6 62/Female 20 0 10 25 15 0 70 No Jha et al[13], 2012
7 55/Female 0 20 10 25 5 10 70 No Ogiso et al[14], 2008
8 56/Female 0 20 20 20 10 0 70 No Yoshino et al[15], 2010
9 50/Male 15 10 10 25 0 10 70 Yes Hosojima et al[16], 1992
10 51/Female 15 10 0 25 15 10 75 No Nai et al[17], 2018
11 52/Male 5 20 10 30 10 0 75 No Andrade et al[18], 2018
12 36/Female 20 10 0 20 15 10 75 No Sugiyama et al[19], 2017
13 24/Female 30 10 10 25 0 10 85 No McMillen et al[20], 2016
14 63/Male 20 10 0 35 5 0 70 No Snyder et al[21], 2020
15 59/Female 10 20 10 25 0 10 75 No Osada et al[22], 2011
16 50/Female 15 20 10 35 10 0 90 No Umezu et al[23], 2013
17 41/Female 10 10 10 35 15 10 90 No Kulaksizoglu et al[24],
2012
18 48/Male 30 10 20 20 0 10 90 No Present case
BT: Body temperature; CNS: Central nervous system; GI-hepatic dysfx.: Gastrointestinal-hepatic dysfunction; CV: Cardiovascular; HF: Heart failure;
Pre.Hx.: Precipitant history.
In this case, the extremely high BT (41.3 °C), elevated pulse rate (PR) (138/min), and altered Glasgow Coma Scale score (E3V1M5) observed on the 2nd day in the ICU were immediately considered to indicate thyroid storm, and treatment was initiated. Severity was assessed at the same time as the diagnosis using the scoring system. The patient was diagnosed with gastric ulcer perforation. Therefore, these symptoms may be considered as signs of sepsis.
To the best of our knowledge, there are some reports of cases with scores of < 70 points; however, there are only 17 reported cases with scores of ≥ 70 points[8-24] (Table 2). Among the 17 cases with scores of ≥ 70 points, two involved mortality. Case 1 involved the highest severity score, with 115 points.
In case 1, the patient had no previous medical or family history of thyroid disease (0 points). Laboratory findings showed liver dysfunction with jaundice (20 points), while physical examination revealed the following: atrial flutter with a PR of 162/min (35 points), high fever (39.3 °C) (20 points), impaired consciousness (30 points), and reduced ejection fraction (43%) with moderate bilateral pleural effusion (10 points). The patient in case 1 was discharged from the hospital on day 94. In the two mortality cases, the severity scores were 80 and 70. In the mortality case with a severity score of 80 points, the central nervous system dysfunction score was very high (30 points). Meanwhile, in the mortality case with a
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Figure 1 Serial changes in heart rate and body temperature. ICU: Intensive care unit; BT: Body temperature; HR: Heart rate.
severity score of 70 points, the cardiovascular dysfunction score was 25 points, which was relatively high compared to other scores. However, the total severity scores in the mortality cases were not relatively high compared to those of other thyroid storm cases. In all 18 cases, including our case, no correlation was found between the severity score and mortality; nevertheless, the number of cases is insufficient to draw a valid conclusion.
Comparing our case to the other 17 cases reported in the literature, we found that our patient presented with extremely high fever and a high severity score. In cases with the same score (cases 2, 16, 17, and 18 [present case]), the highest-scored factor differed between cases. Meanwhile, cases 2, 16, and 17 had high scores for cardiovascular dysfunction (PR > 140/min with atrial fibrillation), and the present case involved a high BT (41.3 °C).
High fever and tachycardia are the main parameters of systemic inflammatory response syndrome, as per the criteria established in 1991[25]. In the Sepsis-3 criteria, newly established in 2016, PR and BT were not included[26]. Although PR and BT were excluded from the diagnostic criteria for sepsis, they are still important in managing sepsis. On the other hand, thyroid storm is not a major consideration in ICU. Therefore, when uncontrolled fever or tachycardia is observed, it may be useful for the physician to consider evaluation of thyroid function. The reason is that sepsis-induced tachycardia and high fever are improved by appropriate sepsis management, but the signs induced by thyroid storm are different in treatment guidelines such as antithyroid agents, Lugol’s solution and steroid etc.
CONCLUSION
In general, thyroid function tests are not performed before emergency surgery for bowel perforation.
Tachycardia and high fever are commonly observed postoperatively. However, since thyroid storm is a life-threatening emergency and mortality is high when treatment is delayed, thyroid function evaluation should not be overlooked when managing sepsis.
FOOTNOTES
Author contributions: Lee JM and Baik SM designed the research study; Lee JM, Baik SM and Pae Y performed the research, analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: The study was approved by the Institutional Review Board (IRB) (approval number:
2021AN0281) and waived the informed consents due to the retrospective study.
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Conflict-of-interest statement: All authors declare that they have no conflicts of interest related to this work.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-
commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Country/Territory of origin: South Korea
ORCID number: Seung Min Baik 0000-0003-1051-6775; Yejune Pae 0000-0002-5493-8606; Jae-Myeong Lee 0000-0001-5494- 0653.
S-Editor: Wang LL L-Editor: A P-Editor: Wang LL
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