Myxedema Coma After Surgical Procedures: Case Report

Myxedema coma is an emergency condition caused by severe hypothroidism. This case report illustrates the difficulties in treating patients with untreated hypothyroidism following emergency surgery. Two patients with myxedema coma, one after appendectomy and the other after carotid endarterectomy are presented in this case report. In the differential diagnosis, Addison crisis, prolongation of duration of muscle relaxant or an intracranial event should be considered. Rapid response to levothyroxine makes diagnosis clear when clinical and laboratory assessments support myxedema coma. It is strongly recommended for the physicians to measure the thyroid hormone levels in patients with risk factors. If myxedema occurs, immediate use of intravenous levothyroxine is effective for this lethal complication.