A 28-year-old man with acromegaly and elevated IGF-1 (680 ng/mL) undergoes transsphenoidal resection of a growth hormone-secreting pituitary adenoma. Postoperatively, he develops polyuria and polydipsia. Vital signs show BP 118/76, HR 92, RR 16, temp 37.2°C. Serum osmolality is 298 mOsm/kg with urine osmolality of 95 mOsm/kg despite adequate fluid intake. Morning cortisol remains normal. Which of the following best explains this complication?
- A)Central diabetes insipidus from ADH deficiencyGABARITO
- B)Hypernatremia from excessive saline administration
- C)Nephrogenic diabetes insipidus from hyperglycemia
- D)Psychogenic polydipsia from surgical stress
- E)Syndrome of inappropriate antidiuretic hormone secretion
Explicação
Postoperative diabetes insipidus is a common complication of transsphenoidal pituitary surgery due to transient or permanent disruption of the pituitary stalk and hypothalamic ADH production. The elevated osmolality (normal <295) with polyuria and polydipsia i... Ver explicação completa e trilha adaptativa →