Duodenal obstruction in thyroid storm.

Abstract:

:A 35-year-old, previously healthy woman, known to be thyrotoxic, was transferred from a community hospital for "acute abdomen." Abdominal pain, distention, and hyperemesis resolved with placement of nasogastric tube (NGT) and return of 2,600 mL of bilious fluid. Continued high NGT output made oral or NGT administration of antithyroid drugs impossible. We gave propylthiouracil (PTU) by retention enemas with therapeutic serum levels and sublingual saturated solution of potassium iodide (SSKI) with 70% absorption based on 24-hour free iodine urinary excretion. The patient's thyroxine (T4) and triiodothyronine (T3) radioimmunoassays were normal on hospital days 10 and 12, respectively. However, free T4 and T3 resin uptake did not normalize until hospital day 31. On hospital day 32, she tolerated removal of NGT without nausea and 4 days later was taking a regular diet. We conclude that our patient's gastrointestinal symptoms were a prominent feature of her thyrotoxicosis and that rectal PTU and sublingual SSKI are effective in administration of antithyroid drugs.

journal_name

South Med J

journal_title

Southern medical journal

authors

Cansler CL,Latham JA,Brown PM Jr,Chapman WH,Magner JA

doi

10.1097/00007611-199711000-00018

subject

Has Abstract

pub_date

1997-11-01 00:00:00

pages

1143-6

issue

11

eissn

0038-4348

issn

1541-8243

journal_volume

90

pub_type

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