Hypertensive Crisis as a Result of Adrenal Venography in a Patient with Pheochromocytoma

Gold, R. E.; Wisinger, Barney M.; Geraci, Anthony R.; Heinz, Leonard M.

doi:10.1148/102.3.579

Cited by 34 publications

(9 citation statements)

References 9 publications

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“…There are case reports describing the use of intravenous contrast as a precipitant for phaeochromocytoma crisis . The majority of these reports relate to the use of high‐osmolality ionic contrast agents, which are now seldom used.…”

Section: Pathogenesismentioning

confidence: 99%

Phaeochromocytoma crisis

Whitelaw

Prague

Mustafa

et al. 2013

Clinical Endocrinology

166

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SummaryPhaeochromocytoma crisis is an endocrine emergency associated with significant mortality. There is little published guidance on the management of phaeochromocytoma crisis. This clinical practice update summarizes the relevant published literature, including a detailed review of cases published in the past 5 years, and a proposed classification system. We review the recommended management of phaeochromocytoma crisis including the use of alpha-blockade, which is strongly associated with survival of a crisis. Mechanical circulatory supportive therapy (including intra-aortic balloon pump or extra-corporeal membrane oxygenation) is strongly recommended for patients with sustained hypotension. Surgical intervention should be deferred until medical stabilization is achieved.

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Section: Pathogenesismentioning

confidence: 99%

Phaeochromocytoma crisis

Whitelaw

Prague

Mustafa

et al. 2013

Clinical Endocrinology

166

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“…Contrast-induced adrenergic crises during arteriography or venography have been reported [4,5]. Raisanen et al noticed a substantial increase in norepinephrine levels after the injection of an ionic contrast media in five of eight patients [6].…”

Section: Discussionmentioning

confidence: 99%

A Case of a Ruptured Pheochromocytoma with an Intratumoral Aneurysm Managed by Coil Embolization

et al. 2003

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Abstract. Although the spontaneous rupture of adrenal pheochromocytoma is rare, it can be lethal because it can induce serious changes in the circulation. We describe a 32 year old man with bilateral pheochromocyroma presenting as abdominal pain. In the emergency room, an abdominal MRI showed an aneurysmal vessel in the right adrenal mass and accompanying hemorrhage around the tumor capsule. The bleeding site was found by transfemoral abdominal angiography. Coil embolization was done in the bleeding vessels, specifically branches of the right adrenal artery. The hemorrhage was successfully controlled and vital signs of the patient were restored. Following emergency care, biochemical and imaging studies showed compatible findings of a bilateral adrenal pheochromocytoma. Postoperative histologic findings confirmed these observations. A ruptured pheochromocytoma should be considered as a cause of acute abdomen in cases of a concomitant adrenal mass. Intratumoral aneurysmal bleeding may be a cause of ruptured tumor, and careful angiographic intervention will help to ensure safe control of bleeding in such an emergency situation, even in cases of bilateral tumor.

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“…Similarly, there have been three reported cases of embolization for traumatic adrenal hemorrhage [7][8][9]. It must be stressed, however, that the decision to proceed to embolization was not taken lightly as there have been reported cases of contrast-induced adrenergic crisis [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Management of Massive Retroperitoneal Hemorrhage from an Adrenal Tumor.

et al. 2001

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Spontaneous massive retroperitoneal hemorrhage from an adrenal gland is a rare event. A thoughtful and meticulous approach to such a patient, with appropriate diagnostic studies, ICU and surgical care are essential for patient survival. In patients with active bleeding, angiographic embolization is a valuable adjunct to achieve hemostasis, to allow for further work-up of the adrenal tumor, and an improved subsequent oncologic resection. Hemodynamically unstable patients, however, may require supportive transfusions in the intensive care unit, potential embolization if deemed feasible, or urgent surgical exploration. If possible, however, the acute surgical removal of an adrenal tumor within a large retroperitoneal hematoma should be avoided, as under such conditions a proper oncologic resection may not be possible. The possibility of a pheochromocytoma must always be entertained. Early recognition and treatment of patients with presumed adrenal insufficiency may decrease patient morbidity and mortality.

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Hypertensive Crisis as a Result of Adrenal Venography in a Patient with Pheochromocytoma

Cited by 34 publications

References 9 publications

Phaeochromocytoma crisis

Phaeochromocytoma crisis

A Case of a Ruptured Pheochromocytoma with an Intratumoral Aneurysm Managed by Coil Embolization

Management of Massive Retroperitoneal Hemorrhage from an Adrenal Tumor.

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