Which condition is a common postoperative complication after hypophysectomy?

Which condition is a common postoperative complication after hypophysectomy?

• A. Diabetes insipidus
• B. Hyponatremia
• C. Hyperglycemia
• D. Hyperkalemia

Answer: (A)

Postoperative diabetes insipidus is the most common complication after hypophysectomy because the surgery can disrupt the posterior pituitary’s ability to release antidiuretic hormone (ADH). ADH normally acts on the kidneys to concentrate urine by promoting water reabsorption in the collecting ducts. When ADH is deficient after surgery, the kidneys excrete large volumes of dilute urine, leading to dehydration and excessive thirst. Clinically this manifests as polyuria and polydipsia, and labs tend to show low urine osmolality with rising serum sodium if fluid intake doesn’t keep up. Management centers on replacing ADH (for example with desmopressin) and carefully balancing fluids and electrolytes. While hyponatremia can occur later if SIADH develops or with fluid management issues, the immediate and classic postoperative issue after hypophysectomy is diabetes insipidus. Hyperglycemia or hyperkalemia are not typical direct complications of this procedure.

Postoperative diabetes insipidus is the most common complication after hypophysectomy because the surgery can disrupt the posterior pituitary’s ability to release antidiuretic hormone (ADH). ADH normally acts on the kidneys to concentrate urine by promoting water reabsorption in the collecting ducts. When ADH is deficient after surgery, the kidneys excrete large volumes of dilute urine, leading to dehydration and excessive thirst. Clinically this manifests as polyuria and polydipsia, and labs tend to show low urine osmolality with rising serum sodium if fluid intake doesn’t keep up. Management centers on replacing ADH (for example with desmopressin) and carefully balancing fluids and electrolytes. While hyponatremia can occur later if SIADH develops or with fluid management issues, the immediate and classic postoperative issue after hypophysectomy is diabetes insipidus. Hyperglycemia or hyperkalemia are not typical direct complications of this procedure.