A 35-year-old woman undergoes total thyroidectomy for papillary thyroid carcinoma. Six hours postoperatively she develops perioral tingling, carpopedal spasm and a positive Chvostek's sign. Serum calcium is 6.8 mg/dL. What is the most likely cause?

• A Recurrent laryngeal nerve injury
• B Thyroid storm
• C Haematoma compressing the trachea
• D Inadvertent parathyroidectomy causing hypoparathyroidism ✓

Explanation

Post-thyroidectomy hypocalcaemia with perioral tingling, Chvostek's sign, and carpopedal spasm indicates hypoparathyroidism from inadvertent removal or devascularisation of the parathyroid glands. It is the most common complication of total thyroidectomy. Recurrent laryngeal nerve injury would cause voice changes, not hypocalcaemia. Haematoma presents with neck swelling and airway obstruction. Thyroid storm is a thyrotoxic crisis with hyperthermia and tachycardia.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.