Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 663-667
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.663
Rare empty sella syndrome found after postoperative hypotension and respiratory failure: A case report
Peng Guo, Zeng-Jun Xu, Chang-En Hu, Yue-Ying Zheng, Dan-Feng Xu
Peng Guo, Zeng-Jun Xu, Chang-En Hu, Dan-Feng Xu, Department of Anesthesiology, Shaoxing Central Hospital, Shaoxing 312000, Zhejiang Province, China
Yue-Ying Zheng, Department of Anesthesiology, the First Affiliated Hospital of Zhejiang University, Hangzhou310000, Zhejiang Province, China
Author contributions: Xu DF and Zheng YY designed the report; Xu ZJ and Hu CE collected the patient‘s clinical data; Guo P wrote the paper.
Supported by the Zhejiang Clinical Funding, No. 2016YC-A86.
Informed consent statement: The patient gave informed consent. Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The guidelines of the CARE Checklist (2016) have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Dan-Feng Xu, MD, Doctor, Department of Anesthesiology, Shaoxing Central Hospital, 1 Huayu Road, Keqiao, Shaoxing 312000, Zhejiang Province, China. xdf@zju.edu.cn
Telephone: +86-575-85580896
Received: January 9, 2019
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

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.