Addison´s Crisis – Schmidt´sSyndrome: Case Report

Overview

Objective:
Addisonian crisis (adrenal crisis) - Schmidt’s syndrome. To show the course, diagnosticmethods and treatment of acute hypocorticism in the patient operated with the symptoms ofacute abdomen.Design: Case report.Setting: Department of Obstetrics and Gynaecology FN UP Olomouc.Case report: Patient (28 years old) treated for primary infertility. Within the ultrasound investigation the solitary myoma in diameter of 7 cm was revealed which deformed the uterine cavity.Patient was admitted to the hospital before the scheduled operation because of the lower abdominal pain, headache, fever and weakness. She got worse and after the surgeon consultation theacute laparotomy was performed with no pathology finding in the abdominal cavity. Plannedmyomectomy was added. During the postoperative course the onset of hypoglycaemic convulsionoccurred with the loss of the consciousness. 24 hours after the operation another deteriorationoccurred with the fever and somnolence. Intraabdominal bleeding was suspected. Relaparotomywas performed with no pathology finding again. Consequently the diagnosis of acute peripheralhypocorticism was set by endocrinologist. After the hydrocortisone substitution the patient rapidly improved.Conclusion: Acute Addison disease can imitate the symptoms of acute abdomen. The endocrinologist’s coperation is needful.

Key words:
acute adrenal insufficiency, adrenal crisis, Schmidt syndrome, Addisonian crisis, operation, acute abdomen