{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:40:22Z","timestamp":1756294822560,"version":"3.44.0"},"reference-count":1,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Hyperparathyroidism is common in the end-stage renal failure and may require surgical intervention. In addition, following multiple vascular access attempts central venous stenosis may occur. The results in high-volume venous blood flow through neck collaterals. Here, we describe a case of severe secondary hyperparathyroidism, high flow arteriovenous fistula and central venous occlusion unresponsive to radiological intervention. A four-gland exploration was undertaken and global parathyroidectomy was performed. Despite meticulous attention to haemostasis, blood loss was considerable from the skin edges although thyroid veins were easily controlled with a drop of 2.1\u2005g\/dl in haemoglobin. Postoperative hypocalcaemia requiring intravenous calcium occurred as expected from the severity of his bone disease (preoperative parathyroid hormone (PTH) 26 times the upper normal range). The patient recovered well, despite a small subcutaneous haematoma and remains asymptomatic.<\/jats:p>","DOI":"10.1136\/bcr-2012-008392","type":"journal-article","created":{"date-parts":[[2013,5,18]],"date-time":"2013-05-18T00:32:42Z","timestamp":1368837162000},"page":"bcr2012008392","source":"Crossref","is-referenced-by-count":0,"title":["Parathyroidectomy in the presence of central venous stenosis"],"prefix":"10.1136","volume":"2013","author":[{"given":"Matthew","family":"Megson","sequence":"first","affiliation":[{"name":"Renal Surgery Department, Queen Elizabeth Hospital Birmingham, Birminhgham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,5,17]]},"reference":[{"key":"2025082704031159000_2013.may17_1.bcr2012008392.1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11864-011-0171-3","article-title":"Parathyroid carcinoma: update and guidelines for management","volume":"2013","author":"Wei","year":"2012","journal-title":"Curr Treat Options Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-008392","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:03:17Z","timestamp":1756292597000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-008392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,17]]},"references-count":1,"alternative-id":["10.1136\/bcr-2012-008392"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-008392","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,5,17]]}}}