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Tetany as a Complication After Strumectomy

100%
Chrzan R., Węgiel J., Kulpa T.
Polish Journal of Surgery
|
2010
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vol. 82
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issue 5
292-296
EN
The study presented a case of a 54-year old woman who developed a fully symptomatic tetany syndrome with tachycardia and Chvostek's (++) sign during the initial 24 hours after subtotal strumectomy. Laboratory parameters demonstrated hypokalemia and hypocalcemia. After the intravenous injection of calcium chloride with simultaneous oral administration of alfacalcidiol, both the calcium and potassium levels returned to normal values.Postoperative tetany is observed in 0.2 to 5.8% of cases, according to literature data. Postoperative hypoparathyroidism may develop after total or subtotal thyroidectomy, as a result of the accidental excision of the parathyroid glands, their damage or vascularization. According to many authors postoperative hypoparathyroidism may result from the ligation of the lower thyroid artery, since these glands, both upper and lower, are supplied by blood in over 90% by the branches of these arteries. Other investigators maintain that tetany may also develop as a result of calcium metabolism disorders. Parathyroid ischemia may also result from pressure of the hematoma formed at the site of the removed thyroid lobes. The above-mentioned complication was probably influenced by a number of factors.
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Hospital physiotherapy after strumectomy

61%
Pasek J., Waler J., Waler N., Pasek T., Wiesztort M., Gawrychowski J., Sieroń A.
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2010
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vol. 18
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issue 4
69-76
PL
Współcześnie w medycynie coraz częściej obserwuje się wzrost zachorowań dotyczących gruczołu tarczowego. Choroby te występują kilkakrotnie częściej u kobiet niż u mężczyzn. Operacyjne usunięcie gruczołu tarczowego, niestety, nadal często stanowi jedyne skuteczne leczenie tego typu schorzeń. Zalecane jest ono najczęściej w przypadku chorych z olbrzymim wolem, z wolem dającym objawy uciskowe na narządy sąsiadujące oraz u chorych z wolem zawierającym guzki zimne (podejrzenie nowotworu złośliwego) lub autonomicznie nadczynne. Nieodzownym elementem leczenia powinno być wczesne uruchamianie chorego, stosowanie wybranych zabiegów i metod kompleksowej fizjoterapii. W pracy przedstawiono szpitalne postępowanie fizjoterapeutyczne przed i po zabiegu strumektomii, które stanowić powinno nieodłączny element leczenia pacjentów na oddziałach chirurgicznych.
EN
The incidence rate of the thyroid gland diseases has been observed to grow at a increasing pace. Thyroid gland diseases occur more often (several times) in women than in men. Unfortunately, in many cases, surgical ablation of the thyroid gland is often the only way of effective treatment. Strumectomy is recommended for patients with gigantic goitre, with goiter giving compression symptoms on neighbouring organs, with goiter containing cold nodules (suspision of malignant neoplasm) or autonomous hyperfunction. It is vital for patients after strumectomy to be mobilized as early as possible after the operation and be subjected to selected procedures of comprehensive rehabilitation. This paper presents physiotherapeutic procedures employed in hospital rehabilitation before and after strumectomy, which the authors recognize as an indispensible element of treatment at surgical wards operating patients with thyroid gland diseases.
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