Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Shinjuku-ku, Japan.
Department of Cardiology, National Center for Global Health and Medicine, Shinjuku-ku, Japan.
Am Surg. 2023 Jun;89(6):2857-2860. doi: 10.1177/00031348211063573. Epub 2021 Dec 28.
Pheochromocytoma is a rare catecholamine producing adrenal tumor. Pheochromocytoma crisis is a life-threatening condition inducing multiple organ failure and hemodynamic instability caused by too much catecholamines produced from pheochromocytoma. We report a 59-year-old woman with pheochromocytoma crisis rescued by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), continuous renal replacement therapy (CRRT), and interval tumor resection. In June 2020, the patient was taken to our institution complaining of headache and left lower back pain. The patient developed cardiopulmonary arrest while at the emergency department. After extracorporeal cardiopulmonary resuscitation, the patient required VA-ECMO for hemodynamic support, and subsequently CRRT for catecholamine removal and acute kidney injury. After 1 month of hemodynamic management, the patient underwent left adrenalectomy. The postoperative course was uneventful and she was discharged on postoperative day 23. CRRT would be a safe and feasible option for catecholamine control in patients with acute kidney injury in pheochromocytoma crisis.
嗜铬细胞瘤是一种罕见的儿茶酚胺分泌性肾上腺肿瘤。嗜铬细胞瘤危象是一种危及生命的疾病，由嗜铬细胞瘤产生的过多儿茶酚胺引起多器官衰竭和血流动力学不稳定。我们报告了一例 59 岁的女性嗜铬细胞瘤危象患者，通过静脉-动脉体外膜肺氧合（VA-ECMO）、连续肾脏替代治疗（CRRT）和间歇性肿瘤切除术得到救治。2020 年 6 月，患者因头痛和左腰痛被送往我院。患者在急诊科时发生心肺骤停。体外心肺复苏后，患者需要 VA-ECMO 进行血流动力学支持，随后进行 CRRT 以去除儿茶酚胺和治疗急性肾损伤。经过 1 个月的血流动力学管理，患者接受了左肾上腺切除术。术后过程顺利，患者于术后第 23 天出院。CRRT 可能是嗜铬细胞瘤危象合并急性肾损伤患者控制儿茶酚胺的一种安全可行的选择。
