Lesson of the month 2: Blunt abdominal trauma: atypical presentation of phaeochromocytoma

Sarah Faloon, Hema Venkataraman, Kassiani Skordilis, Ewen A Griffiths, Neil Jl Gittoes, Zaki K Hassan-Smith, John Ayuk

Research output: Contribution to journalArticlepeer-review


A 26-year-old man presented following blunt abdominal trauma to a regional major trauma centre for emergency embolisation of a retroperitoneal bleed from a presumed renal laceration. Imaging had also revealed a large right suprarenal mass. Embolisation resulted in a hypertensive crisis raising the suspicion of a metabolically active adrenal tumour. The course was further complicated by the development of ischaemic bowel requiring emergency laparotomy. Intraoperatively he became haemodynamically unstable from an actively haemorrhaging lesion. Emergency laparotomy and adrenalectomy was performed as a life-saving procedure. Histology confirmed a phaeochromocytoma. The patient made a gradual recovery and was discharged home with no sequelae. Definitive management of phaeochromocytoma is surgical resection which requires prolonged preoperative optimisation with alpha receptor blockers to adequately control blood pressure and prevent hypertensive crises. Parenteral alpha receptor blockers, such as phentolamine, are optimal treatment for intraoperative hypertensive emergencies, yet they are currently not available in the UK.

Original languageEnglish
Pages (from-to)345-347
Number of pages3
JournalClinical Medicine
Issue number4
Publication statusPublished - 2 Aug 2018


  • Abdominal Injuries/complications
  • Adrenal Gland Neoplasms/complications
  • Adult
  • Emergencies
  • Humans
  • Laparotomy
  • Male
  • Pheochromocytoma/complications
  • Tomography, X-Ray Computed
  • Wounds, Nonpenetrating/complications


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  • Response

    Hassan-Smith, Z., Faloon, S., Gittoes, N. & Ayuk, J., Jan 2019, In: Clinical Medicine. 19, 1, p. 92

    Research output: Contribution to journalLetter, comment/opinion or interview

    Open Access

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