PDF(Pubmed)
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.
摘要：
高钙血症是一种常见的电解质异常，具有不同的原因。高钙血症通常与恶性肿瘤有关，原发性甲状旁腺功能亢进和恶性肿瘤一起占大多数病例。由于甲状旁腺激素的过量产生，原发性甲状旁腺功能亢进表现为高钙血症。在大多数情况下,原发性甲状旁腺功能亢进表现为单发甲状旁腺腺瘤。根据钙水平,高钙血症可以归类为轻度，中度,和严重。高钙血症通常表现为非特异性临床特征。这里,我们介绍了一例38岁的男性患者,他因急性腹痛和腹部疼痛,肠鸣音缺失而就诊于急诊科(ED).他最初做了胸部X光检查和血液检查。胸片显示左侧气腹,在2019年第二波冠状病毒病(COVID-19)大流行期间,患者被怀疑患有由甲状旁腺腺瘤继发的高钙血症引起的消化性溃疡穿孔.腹部计算机断层扫描扫描证实了这一发现，在多学科小组会议(MDT)讨论后,患者接受了高钙血症静脉输液治疗,并保守治疗了密封穿孔性消化性溃疡.COVID-19大流行导致了漫长的等待名单，并延误了对需要择期手术干预的患者的及时管理，如甲状旁腺切除术。患者完全康复，并在两个月后对右下叶进行了甲状旁腺切除术。
