Traumatic haemorrhage into an occult phaeochromocytoma: presentation and management in a patient with septic shock.
Anaesthesia
; 63(4): 428-32, 2008 Apr.
Article
in En
| MEDLINE
| ID: mdl-18336495
ABSTRACT
Phaeochromocytomas can have a variety of presentations; however, traumatic haemorrhage into a phaeochromocytoma is a rare presentation. Diagnosing and managing a critically ill, septic patient with a phaeochromocytoma can be very challenging. We report a case of a 57-year-old man, with a previously undiagnosed phaeochromocytoma, who presented initially with bowel perforation following an assault. Following a laparotomy for bowel resection and anastomosis, whilst on the intensive care unit, he developed paroxysmal severe hypertension overlying septic shock. Phaeochromocytoma was confirmed using a computed tomography scan and urinary assay of metanephrines and catecholamines. We managed the haemodynamic instability using labetalol and noradrenaline infusions. As his septic state improved he was started on conventional therapy and following control of his symptoms over the next few weeks, he underwent an uncomplicated right sided adrenalectomy. He made a full recovery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pheochromocytoma
/
Shock, Septic
/
Adrenal Gland Neoplasms
/
Hemorrhage
Type of study:
Diagnostic_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Anaesthesia
Year:
2008
Document type:
Article
Affiliation country:
United kingdom