ADRENOCORTICAL RESPONSE TO SURGICAL OPERATIONS IN PATIENTS TREATED WITH CORTICOSTEROIDS OR CORTICOTROPIN PRIOR TO SURGERY

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Abstract
The free plasma 17-OHCS response to preoperative intravenous ACTH and to surgical operation was measured in 6 patients who had been receiving prolonged corticosteroid therapy; in 4, the plasma 17-OHCS conjugate levels were also determined. The plasma 17-OHCS response to preoperative ACTH was diminished in all 6 patients, but in 2 of them the free plasma 17-OHCS levels noted postoperatively were within the normal range expected following surgery. In contrast to the foregoing group were 2 patients who had received long-acting ACTH preparations for ulcerative colitis. Their plasma 17-OHCS response to both ACTH and to total colectomy was notmal. It is suggested that patients who have been treated only with ACTH prior to surgery may be expected to have a normal pituitary-adrenal response to operation.