Year : 2010 | Volume : 3 | Issue : 3 | Page : 300-
Traumatic haemorrhage of occult phaeochromocytoma in a patient with septic shock
Mohammad Shahnawaz Moazzam, Syed Moied Ahmed, Shahjahan Bano
Department of Anaesthesiology & Critical Care, Faculty of Medicine, J.N. Medical College, AMU, Aligarh, U.P.-202 002, India
Phaeochromocytoma can have a variety of presentations; however, traumatic haemorrhage into a phaeochromocytoma is a very rare presentation. Diagnosing and managing a critically ill, septic patient with a Phaeochromocytoma can be very challenging. We report a case of 53 years 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 metanephrine and catecholamines. We managed the haemodynamic instability using labetalol and noradrenaline infusions. As his septic state improved he was convention therapy and following control of his symptoms over the next few weeks, he underwent an uncomplicated right sided adrenalectomy. He made a full recovery.