Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.663
Peer-review started: January 10, 2019
First decision: January 19, 2019
Revised: February 4, 2019
Accepted: February 18, 2019
Article in press: February 18, 2019
Published online: March 6, 2019
Core tip: A 60-year-old man was admitted for internal fixation of the left clavicle. General anaesthesia with a nerve block was administered. His blood pressure continued to decrease post-operation. Endocrine tests were performed, with the results supporting a diagnosis of hypopituitarism. Brain magnetic resonance imaging demonstrated that the sella was enlarged and filled with cerebrospinal fluid, confirming a diagnosis of empty sella syndrome. The patient was started on endocrine replacement therapy. The patient regained consciousness and spontaneous breath finally. This case highlights the importance of considering pituitary hormone insufficiency in the context of respiratory and hemodynamic failure during the perioperative period.