A patient who underwent a thyroidectomy 24 hours ago develops numbness and tingling around the lips and fingertips, muscle twitching, and positive Chvostek and Trousseau signs. What acute post-surgical complication has occurred?

Answer and explanation

Correct answer: D. Accidental devascularization or excision of the parathyroid glands causing acute hypocalcemia

  1. Step 1: The parathyroid glands lie on the posterior capsule of the thyroid gland.
  2. Step 2: Accidental surgical removal or vascular compromise during thyroidectomy results in rapid decline of parathyroid hormone (PTH), causing acute hypocalcemia characterized by perioral paresthesias, neuromuscular tetany, and positive Chvostek and Trousseau signs within 24 to 48 hours.
Answer
Accidental devascularization or excision of the parathyroid glands causing acute hypocalcemia.
Why not the others: 'Thyroid storm' presents with extreme hyperthermia, delirium, and tachycardia, not hypocalcemic tetany; 'Recurrent laryngeal nerve injury' causes vocal hoarseness (unilateral) or acute stridor/airway obstruction (bilateral); 'Tracheomalacia' causes dynamic inspiratory airway collapse.

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