Shock thyroid is an uncommon part of the hypovolaemic shock complex.
It was initially described in 2006 as heterogeneous thyroid contrast enhancement and fluid surrounding the thyroid on trauma CT of shocked patients without evidence for direct thyroid injury 2. Only eight cases have been described as of 2021 1-3. It is probably under-recognised but it is unknown whether there are any clinical implications in the shocked patient.
Pathology
It is hypothesised that shock thyroid results from a combination of hypoperfusion of the thyroid gland causing intracellular oedema and death and transient thyrotoxicosis in response to hypovolaemia 2. Most cases described are due to shock secondary to trauma.
Imaging features
CT
In the absence of evidence of direct thyroid injury, the thyroid may be enlarged with heterogeneous contrast enhancement which may mimic a multinodular gland. Low density fluid tracks around the thyroid with density of -5 to 10 HU 1. Typically there are other signs of the hypovolaemic shock complex in the chest and abdomen.
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