Abstract
Myxedema coma occurs when hypothyroidism is neglected without treatment for a long term. Progressive disturbance of consiousness is the main sign of the disease and results in serious coma.
Recently a case of respiratory failure due to myxedema coma after colonic surgery was experienced. A 75-year-old woman was admitted to the hospital because of lower abdominal fullness. Emergency laparotomy was carried out under a diangosis of volvulus of the sigmoid colon.
Postoperatively, endocrine functional tests were ordered because of delayed postanesthetic recovery and primary hypothyroidism was found. She recovered well under administration of thyroid hormone and adrenal corticosteroids in spite of the sudden attack of respiratory failure.
Myxedema coma is very rare in surgical cases. The mortality rate is 50-80%, prognosis is very poor. A concealed myxedema coma should be considered before surgery and the immediate administration of thyroid hormone is effective.
Endocrine functional test is mandatory when a patient appears delayed recovery from anesthesia and or has a sudden onset of respiratory failure.
