2019 Volume 39 Issue 6 Pages 1171-1174
A 67-year-old woman was transported to our emergency outpatient department for continuous vomiting and abdominal pain while taking medicine prescribed by her previous doctor. She had undergone pituitary tumor resection 6 years prior and was receiving hormone replacement therapy. She presented with sudden-onset hypotension during the examination. Although sufficient fluid resuscitation and vasopressors were administered, she continued to exhibit hypotension and her serum lactate level was high. The physical examination suggested intestinal necrosis, which needed to be confirmed. As she had contrast agent allergy, we performed a laparoscopic examination instead of contrast CT to investigate the condition of the intestines. We changed to laparotomy because of a poor visual field due to distention of the intestines but found no necrotic change. She recovered after the administration of antibiotics and hormone replacement therapy after surgery. On the 4th day, Salmonella species O8 was cultured from blood and fecal samples; therefore, we suspected adrenal insufficiency caused by Salmonella enteritidis.
