A case of carcinoma larynx with overt hypothyroidism scheduled for feeding jejunostomy

Abstract

The function of the thyroid gland is to secrete sufficient amount of thyroid hormones for regulation of cellular metabolism throughout the body. Patients need medical care for hyper functioning (hyperthyroidism) or hypo functioning (hypothyroidism) of the thyroid gland. Hypothyroidism is a very common disease affecting 0.5% to 0.8% of the adult population in the world. Primary hypothyroidism results in a decreased production of thyroid hormones despite adequate or increased levels of TSH and accounts for 95% of all cases of hypothyroidism. Secondary hypothyroidism results due to hypothalamic or pituitary disease that accounts for 5% of cases of hypothyroidism [1]. Hypothyroidism can cause decreased myocardial contractility, baroreceptor dysfunction, weight gain, non-pitting edema, hyponatremia, decreased ventilatory response to hypoxia and hypercarbia, diminished gastrointestinal function and impaired drug metabolism. Feeding jejunostomy is a surgical procedure by which a tube is inserted in the lumen of the proximal jejunum, primarily to provide enteral nutrition or administer medications. This procedure becomes a vital path for providing nutrition and medication when a person becomes unable to swallow due to obstruction of the food pipe [2]. Carcinoma larynx is a disease in which malignant cells originate from larynx mostly squamous-cell carcinomas which can invade the surrounding structures. Here, we report on the anaesthetic management of a patient of carcinoma larynx with overt hypothyroidism for feeding jejunostomy.