Profound postoperative hypoglycemia in a malnourished patient.
OBJECTIVE
To present an unusual case of profound postoperative hypoglycemia resulting in irreversible brain damage in a malnourished patient.


METHODS
A 56-yr-old malnourished woman underwent laparotomy for intestinal obstruction under general anesthesia. Five hours postoperatively she was found to be unresponsive with an immeasureably low blood glucose level. This event was not associated with hyperinsulinemia. Predisposing factors like diabetes mellitus, pheochromocytoma, insulin secreting tumours, adrenal or pitutary deficiency were absent. She was treated with iv dextrose and hydrocortisone with blood glucose levels stabilizing fairly rapidly. However, she unfortunately had sustained irreversible cerebral damage and is left with significant neurological disability.


CONCLUSIONS
Severe postoperative hypoglycemia has several well documented causes. Although hypoglycemia does occur to a moderate degree in malnutrition, it has not been reported to be so severe as to cause cerebral damage in the postoperative setting.
Kurian
J
J
Department of Anaesthesia and General Surgery, Worthing Hospital NHS Trust, Worthing, United Kingdom. joneskurian@yahoo.co.uk
Kaul
V
V
D001925:Brain Damage, Chronic / Q000209:etiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000209:etiology*; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications*; D011183:Postoperative Complications