During bilateral adrenalectomy, intra-operative dose of hydrocoisone should be given after:: (A) Opening the abdomen, (B) Ligation of left adrenal vein, (C) Ligation of right adrenal vein, (D) Excision of both adrenal glands
Answer is D. Patients undergoing surgical treatment of endogenous hypercoisolism require glucocoicoid replacement. Steroids are not given pre-operatively because these patients are already hypercoisolemic. Instead hydrocoisone 100 mg IV is given after the removal of second hyperplastic adrenal gland.