[Hemodynamic instability and paraplegia after thoracotomy for excision of a cardiac pheochromocytoma].
We report the occurrence of a sustained hypotension (vasoplegia) following thoracic phaeochromocytoma surgery. Diagnosis of spinal cord injury was done by magnetic nuclear resonance (MNR) showing surgical "Horsley wax" inside the vertebral canal and ischaemic signal inside the anterior part of the spine cord. Removal of "Horsley wax" dramatically improved arterial blood pressure but did not correct all neurologic disorders. Haemodynamic disorders related to spinal cord injury are rare after thoracotomy, and may have been enhanced by the haemodynamic instability typically associated with phaeochromocytoma surgery. Early diagnosis has to be done by MNR.
Decoene
C
C
Service d'anesthésie-réanimation en cardiologie, CHRU, 59037 Lille, France. c-decoene@chru-lille.fr
Tavernier
B
B
Jegou
B
B
Pol
A
A
Proye
C
C
D006338:Heart Neoplasms / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology*; D010673:Pheochromocytoma / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D013116:Spinal Cord / Q000098:blood supply; D013119:Spinal Cord Injuries / Q000503:physiopathology; D013908:Thoracotomy