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A Rare Manifestation of Unknown Hyperparathyroidism as a Perforated Peptic Ulcer.
Mlawa, Gideon; Khan, Zahid; Azhar, Sabeen; Hussein, Furhana; Mahamud, Bashir; Nugod, Abdulrahman.
  • Mlawa G; Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals National Health Services (NHS) Trust, London, GBR.
  • Khan Z; Acute Medicine, Mid and South Essex National Health Services (NHS) Foundation Trust, Southend on Sea, GBR.
  • Azhar S; Cardiology, Bart's Heart Center, London, GBR.
  • Hussein F; Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals National Health Services (NHS) Trust, London, GBR.
  • Mahamud B; Cardiology, Royal Free Hospital, London, GBR.
  • Nugod A; Acute Medicine, Queen's Hospital, London, GBR.
Cureus ; 15(4): e37635, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2324976
ABSTRACT
Hypercalcemia is a common electrolyte abnormality with different causes. Hypercalcemia is most often associated with malignancy and primary hyperparathyroidism and malignancy together account for most cases. Primary hyperparathyroidism manifests as hypercalcemia owing to the overproduction of parathyroid hormone. In most cases, primary hyperparathyroidism manifests due to a solitary parathyroid adenoma. Based on calcium levels, hypercalcemia can be classified as mild, moderate, and severe. Hypercalcemia typically presents with non-specific clinical features. Here, we present the case of a 38-year-old male patient who presented to the emergency department (ED) with acute abdominal pain and a tender abdomen with absent bowel sounds. He had chest radiography and blood tests initially. Chest radiography showed left-sided pneumoperitoneum, and the patient was suspected to have a perforated peptic ulcer due to hypercalcemia secondary to a parathyroid adenoma during the second wave of the coronavirus disease 2019 (COVID-19) pandemic. The findings were confirmed by a computerized tomography scan of the abdomen, and the patient was treated with intravenous fluids for hypercalcemia and was managed conservatively for a sealed perforated peptic ulcer following discussion in the multi-disciplinary team meeting (MDT). The COVID-19 pandemic led to a long waiting list and delays in the timely management of patients requiring elective surgical intervention, such as parathyroidectomy. The patient made a complete recovery and had parathyroidectomy of the inferior right lobe two months later.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Cureus Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Cureus Year: 2023 Document Type: Article