Features of diagnostics and treatment of thyrotoxicosis in patients with severe comorbid pathology: clinical case

Abstract

Objective. To demonstrate the stages of diagnostics and successful treatment of thyrotoxicosis in a patient with severe comorbid pathology.
 Materials and methods. A clinical case report of a patient with toxic goiter is presented.
 Results. To specify the state of the thyroid gland, diagnostic and laboratory methods were applied: ultrasound examination (thyroid volume increased up to 182 cm2, isoechogenic nodule in the left lobe up to 1 cm, thyroid vascularization increased), spiral computed tomography (picture of diffuse nodular goiter with partial retrosternal location of the left thyroid lobe), hormone studies, the results of which revealed thyrotoxicosis. Thyroidectomy was subsequently carried out. Both thyroid lobes with isthmus were removed step-by-step with technical difficulties and high bleeding of tissues. The patient was discharged in 10 days in a satisfactory state.
 Conclusions. Thyrotoxicosis is certainly a complex surgical pathology, in which correct assessment of the diagnosis by instrumental, clinical and laboratory methods is required, as well as successful surgical intervention. Not only normalization of hormonal status of a patient has to be taken into account, but also the possibility of disease relapse, contraindications due to age, physiological status, and comorbid abnormalities.

Clinical case of development of thromboembolism after thyroidectomy with concomitant diseases

“…Это грозное осложнение наибо лее часто развивается при инсульте (56 %), инфаркте миокарда (22 %), острых терапев тических заболеваниях (16 %), новообразо ваниях (15 %), а также у лиц преклонного возраста (9 %). Тромбоэмболия легочной артерии при аутопсии обнаруживается у 12-15 %, при этом 68 % этих смертей мож но предотвратить [2][3][4][5].…”

The Character of Purulent-Inflammatory Diseases of The Retroperitoneal Region

“…Up to 14% of all kidney diseases is pyelonephritis in the acute phase, while 30% of patients develop various forms of purulent pyelonephritis (apostematous pyelonephritis, abscess, carbuncle). Most frequently, purulent kidney diseases lead to a total purulent-destructive disease of the retroperitoneal space and complicate the tasks of the surgeon in terms of surgical treatment [3,4,11].In recent years, clinical cases have been observed in surgical practice, when a purulent-inflammatory process spreads distally to the inguinal area and thigh. This pattern is most often observed in patients with diabetes mellitus and indicates improvements in the existing surgicalstandards for the treatment of such a contingent of patients [5,7].…”