Sheehan's syndrome: A rare cause of delayed recovery after anesthesia

• Main Authors: Garima Choudhary, Shikha Soni, Sadik Mohammed
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Obstetric Anaesthesia and Critical Care
• Subjects: amenorrhea; electrolyte imbalance; hypopituitarism; postpartum hemorrhage; sheehan's syndrome
• Online Access: http://www.joacc.com/article.asp?issn=2249-4472;year=2020;volume=10;issue=1;spage=58;epage=60;aulast=Choudhary

Sheehan's syndrome (SS) or adenohypophyseal insufficiency is a rare but known complication of postpartum hemorrhage (PPH). It develops as result of ischemic pituitary necrosis secondary to a brutal and extended shock due to obstetric hemorrhage. The clinical presentation of this syndrome is variable and marked with abrupt or insidiously developing pituitary insufficiency. We report a case of 35-year-old female scheduled for laparoscopic appendicectomy under general anesthesia who developed delayed recovery. Proper history revealed that patient had history of severe PPH and was amenorrheic after that for last 4 years. Investigation revealed that pan hypopituitarism and neuroimaging (magnetic resonance imaging) showed reduced pituitary size. Replacement of deficient hormone leads to recovery and weaning from mechanical ventilation.