Abstract

  The pheochromocytoma is responsible for the excessive release of adrenaline and norepinephrine which leads to hypertensive flare-ups, dysrhythmias, strokes and pre-operative myocardial ischemia. This makes perioperative hemodynamic instability the greatest surgical and anesthetic challenge in surgery for a pheochromocytoma, hence the need for patient preparation with appropriate medications. This hemodynamic instability occurs in a large proportion of post-operative patients who often require vasopressor agents. Management of these hemodynamic disorders has improved outcomes by reducing both mortality and morbidity.

  We report a case of a pheochromocytoma patient who underwent adrenalectomy, whose cardiac problems were aggravated postoperatively and were controlled by the administration of vasoactive drugs in the resuscitation setting.

Keywords: Pheochromocytoma; Adrenalectomy; Surgery; Cardiovascular Complications

References

1. Magagi Amadou., et al. “Particularity of anesthesia for surgical treatment of pheochromocytoma: about a case”. Pan African Medical Journal 29.1 (2018): 1-4.
2. Grise P and Kuhn J. “Surgical treatment of pheochromocytoma”. Nephrology-Urology (2002): 18-185.
3. Loosli Nicolas., et al. “Pheochromocytoma and paraganglioma”. Swiss Medical Journal 10.441 (2014): 1650-1652. 
4. Pacak Karel. “Preoperative management of the pheochromocytoma patient”. The Journal of Clinical Endocrinology and Metabolism 92.11 (2007):  4069-4079. 
5. Vandwalle J., et al. “Pheochromocytoma and heart failure: an exceptional indication for emergency or semi-emergency adrenalectomy”. Advances in Urology 20.7 (2010):  498-502.
6. Thompson Jesse E., et al. “Pheochromocytoma; surgical and anesthetic management”. Anesthesiology 15.6 (1954): 658-665.
7. Pisarska Magdalena., et al. “Perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma”. Gland Surgery 5.5 (2016): 506.
8. Desmonts JM and Et Marty JI. “Anaesthetic management of patients with phaeochromocytoma”. British Journal of Anaesthesia 56.7 (1984): 781-789.
9. Akiba Masako., et al. “Hypoglycemia induced by excessive rebound secretion of insulin after removal of pheochromocytoma”. World Journal of Surgery 14.3 (1990): 317-324.

Citation

Citation: Taoufik Elabbassi., et al. “Hemodynamic and Cardiovascular Disorders During Surrenalectomy for Pheochromocytoma". Acta Scientific Medical Sciences 4.4 (2020): 07-09.

Copyright

Copyright: © 2020 Taoufik Elabbassi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.