Hosamani Shridhar, Ghuliani Deepak, Puttaswamy Rajshekar
Department of Surgery, Maulana Azad Medical College, New Delhi, IND.
Department of Surgical Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.
Cureus. 2023 Mar 29;15(3):e36890. doi: 10.7759/cureus.36890. eCollection 2023 Mar.
Pheochromocytoma is a neuroendocrine tumor arising from the adrenal medulla, which often causes an adrenalin rush in the treating surgeon and the anesthesiologist. The tumor rupture presenting as acute abdomen and shock is a rare and life-threatening event. We present a case report of ruptured metastatic pheochromocytoma in a 37-year-old patient whose signs and symptoms included acute abdomen and shock. The exact mechanism causing the spontaneous rupture of a tumor is not clearly understood although some theories are proposed. CT scan is the most important investigation in this emergency. A high index of suspicion is needed to diagnose rupture in a known case of pheochromocytoma presenting with acute abdomen and shock. Ruptured pheochromocytoma is a rare emergency, and timely and precise diagnosis and initial primary nonsurgical approach followed by elective surgical resection are to be practiced whenever possible. When emergency exploration is imminent, a multi-specialty team should be prepared with a well-equipped ICU, rapid hemodynamic monitoring and corrections, massive blood transfusion protocol, and timely resuscitation.
嗜铬细胞瘤是一种起源于肾上腺髓质的神经内分泌肿瘤，常常会让主刀外科医生和麻醉医生肾上腺素激增。肿瘤破裂表现为急腹症和休克，是一种罕见且危及生命的情况。我们报告一例37岁转移性嗜铬细胞瘤破裂的病例，其体征和症状包括急腹症和休克。尽管提出了一些理论，但肿瘤自发破裂的确切机制尚不清楚。CT扫描是该急症最重要的检查手段。对于已知患有嗜铬细胞瘤且出现急腹症和休克的病例，需要高度怀疑才能诊断出破裂。破裂的嗜铬细胞瘤是一种罕见的急症，应尽可能及时、准确地诊断，并首先采取非手术的初步治疗方法，随后进行择期手术切除。当即将进行急诊探查时，应组建一个多专业团队，并配备设备完善的重症监护病房、快速血流动力学监测与纠正措施、大量输血方案以及及时的复苏措施。
