Postsurgical psychosis: Case report and review of literature

Abstract

A wide range of behavioral symptoms may occur following surgery, including depression, hallucinations, true psychosis, mania, and impulsivity. Psychoses, including those that occur postoperatively, are among the most frequent indications for hospitalization in the United States and are associated with a substantially increased rate of morbidity. The exact cause of postoperative psychosis has not been identified. A 59-year-old woman who developed acute psychosis after cholecystectomy is described here. The patient was brought to Mount Vernon Hospital in New York because she exhibited acute disruptive behavior following endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy performed on 2 consecutive days. The patient was psychotic and was unable to be managed; she was disorganized, confused, and perplexed. Findings of computed tomography of the head, electroencephalography, and chemical and hematologic tests were normal. The patient was treated with lorazepam 1 mg every 6 h, olanzapine 5 mg at bedtime, and clonazepam 1 mg at bedtime. She experienced a mixture of auditory and visual hallucinations with a paranoid perspective and was then treated with haloperidol 5 mg, diphenhydramine chloride 25 mg, and divalproex sodium 500 mg. After 1 wk, the patient was described as acutely psychotic; antipsychotic medication dosages were readjusted and the patient's condition stabilized. The association between surgical procedures and psychosis is thoroughly reviewed here. Awareness, ability to diagnose, and an understanding of the cause of psychotic symptoms that emerge following surgery must be established if physicians are to provide better care and more effective treatment.

Non-reproductive triggers of postpartum psychosis

“…There is a scanty literature on the occurrence of psychosis after surgical operations (Abdullah et al 2006). Because of the great variety of surgical procedures, the range of disorders that require them and the complications of anaesthetics and analgesics, this is a complex subject; for example, there is a literature on the psychoses that follow surgery for temporal lobe epilepsy, and there are post-operative confusional states.…”

Post-surgical acute psychotic episode – case report

“…Postoperative or post-anaesthetic psychoses generally occur in the context of delirium syndrome [3]. However, isolated cases are cited in the literature where psychotic symptoms occur with clear consciousness and without cognitive deficits [4].…”

Μετεγχειρητικές Επιπλοκές Και Σχετιζόμενη Με Την Υγεία Ποιότητα Ζωής Μετά Από Ορθοτοπική Μεταμόσχευση Ήπατος Και Μείζονες Ογκολογικές Επεμβάσεις Για Πρωτοπαθείς Ή Δευτεροπαθείς Όγκους Γαστρεντερικού Συστήματος Σε Ασθενείς Που Νοσηλεύθηκαν Σε Μονάδα Εντατικής Θεραπείας

“…Επιβαρυντικοί παράγοντες είναι ο μετεγχειρητικός πόνος, η έλλειψη ύπνου, η απομόνωση και το μη γνώριμο περιβάλλον. Μετά τη λήξη της νοσηλείας και της ανάρρωσης ο ασθενής επανέρχεται στη προηγούμενη διανοητική κατάσταση (113,141,142) .…”