caa a22 4500 445372753 CHVBK 20180317142952.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00540-010-1070-7 doi (NATIONALLICENCE)springer-10.1007/s00540-010-1070-7 Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation [Elektronische Daten] [Takashi Matsusaki, Hiroshi Morimatsu, Junya Matsumi, Hiroaki Matsuda, Tetsufumi Sato, Kenji Sato, Satoshi Mizobuchi, Takahito Yagi, Kiyoshi Morita] Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis. Japanese Society of Anesthesiologists, 2010 Pituitary apoplexy nationallicence Diabetes insipidus nationallicence Living donor liver transplantation nationallicence LDLT : Living donor liver transplantation nationallicence FFP : Fresh frozen plasma nationallicence BMI : Body mass index nationallicence AST : Aspartate aminotransferase nationallicence ALT : Alanine aminotransferase nationallicence PT-INR : Prothrombin time-International normalized ratio nationallicence APTT : Activated partial thromboplastin time nationallicence AT-III : Antithrombin III nationallicence CT : Computed tomography nationallicence DDAVP : Deamino-8-D-arginine-vasopressin nationallicence Matsusaki Takashi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Morimatsu Hiroshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Matsumi Junya Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Matsuda Hiroaki Department of Surgery, Okayama University Medical School, Okayama, Japan aut Sato Tetsufumi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Sato Kenji Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Mizobuchi Satoshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Yagi Takahito Department of Surgery, Okayama University Medical School, Okayama, Japan aut Morita Kiyoshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut Journal of Anesthesia Springer Japan 25/1(2011-02-01), 108-111 0913-8668 25:1<108 2011 25 540 https://doi.org/10.1007/s00540-010-1070-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1070-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Matsusaki Takashi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Morimatsu Hiroshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Matsumi Junya Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Matsuda Hiroaki Department of Surgery, Okayama University Medical School, Okayama, Japan aut NATIONALLICENCE 700 1- Sato Tetsufumi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Sato Kenji Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Mizobuchi Satoshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Yagi Takahito Department of Surgery, Okayama University Medical School, Okayama, Japan aut NATIONALLICENCE 700 1- Morita Kiyoshi Department of Anesthesiology and Resuscitology, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Okayama, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/1(2011-02-01), 108-111 0913-8668 25:1<108 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer