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Pituitary Apoplexy Following Endoscopic Retrograde Cholangiopancreatography.
Crisman, Celina; Ward, Max; Majmundar, Neil; Damodara, Nitesh; Hsueh, Wayne D; Eloy, Jean Anderson; Liu, James K.
Affiliation
  • Crisman C; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Ward M; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Majmundar N; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Damodara N; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Hsueh WD; Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Eloy JA; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
  • Liu JK; Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA. Electronic address: james.liu.md@rutgers.edu.
World Neurosurg ; 121: 201-204, 2019 Jan.
Article in En | MEDLINE | ID: mdl-30292038
BACKGROUND: Pituitary apoplexy is an uncommon neurosurgical emergency that may be the initial presentation of undiagnosed pituitary adenomas. Though the exact pathogenesis is unclear, there appears to be an association between pituitary apoplexy and medical interventions that disturb the blood supply and venous drainage of the abnormal sellar region. We present the first case of pituitary apoplexy occurring after an endoscopic retrograde cholangiopancreatography (ERCP). CASE DESCRIPTION: A 43-year-old male who was several hours status post ERCP presented with a severe headache, bilateral ptosis, and multidirectional ophthalmoplegia. Computed tomography scan and magnetic resonance imaging of the brain revealed a hemorrhagic and necrotic sellar mass with suprasellar extension compressing the optic chiasm and bilateral extension displacing the cavernous carotid arteries laterally. The patient underwent emergent endoscopic endonasal transsphenoidal resection of the underlying pituitary tumor apoplexy with eventual resolution of his cranial nerve palsies. CONCLUSIONS: Although pituitary apoplexy has been recognized as a sequela of surgical and laparoscopic procedures, it should also be considered in less invasive gastrointestinal procedures which may alter the intraabdominal pressures, such as ERCP. Early detection of this unusual complication allows for rapid diagnosis and timely surgical intervention in select cases to prevent debilitating cranial nerve palsies, preserve visual function, and retain normal pituitary function.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Pituitary Apoplexy / Cholangiopancreatography, Endoscopic Retrograde Type of study: Diagnostic_studies / Screening_studies Limits: Adult / Humans / Male Language: En Journal: World Neurosurg Journal subject: NEUROCIRURGIA Year: 2019 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Pituitary Apoplexy / Cholangiopancreatography, Endoscopic Retrograde Type of study: Diagnostic_studies / Screening_studies Limits: Adult / Humans / Male Language: En Journal: World Neurosurg Journal subject: NEUROCIRURGIA Year: 2019 Document type: Article Affiliation country: United States Country of publication: United States