Journal of clinical anesthesia
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Sheehan's syndrome is a well described entity that refers to hypopituitarism with pituitary infarction secondary to postpartum shock or hemorrhage. Antepartum pituitary infarction is a very rare condition that has been reported only in patients with longstanding type 1 diabetes mellitus or uncontrolled gestational diabetes. A case of severe, acute hypopituitarism in the setting of hemorrhagic shock from a gunshot wound is presented. Our case report highlights the importance of including hypopituitarism in the differential diagnosis of a critically ill parturient.
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Repair of a retinal detachment was performed during a retrobulbar block with monitored anesthesia care and intravenous conscious sedation. Following the procedure and after removal of the sterile drapes, the patient exhibited significant swelling of the bilateral orbits, face, neck, and chest. Subcutaneous emphysema and pneumomediastinum were confirmed on postoperative chest radiographs and computed tomographic scans. Possible mechanisms and potential sequelae of this intraoperative event are discussed.