[Hyperaldosteronism persisting after subtotal adrenalectomy].
BACKGROUND
Primary aldosteronism is known to be caused by aldosterone-producing adenoma (APA). Total adrenalectomy is the standard procedure. In contrast to bilateral adrenal diseases (e.g., MEN II pheochromocytomas), there is no consensus about the effect of subtotal adrenalectomy.


METHODS
A 44-year-old patient with primary aldosteronism caused by APA underwent subtotal adrenalectomy including removal of one adenoma. Because hypertension and hypokalemia did not disappear and hyperaldosteronism persisted, the patient had to undergo reoperation in which the adrenalectomy was completed.


CONCLUSIONS
Subtotal adrenalectomy in patients with Conn's syndrome is an interesting therapeutic option,whereas its effect is much higher in hereditary diseases of the adrenal gland. The benefit of preserved adrenal tissue has to be weighed against a possible persistence of hyperaldosteronism, especially in cases with normal opposite adrenal glands.
Klinik für Visceral-,Thorax- und Gefässchirurgie, Philipps-Universität marburg. fendrich@med.uni-marburg.de.
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Fendrich
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Ramaswamy
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Nies
D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000328:Adult; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006973:Hypertension / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007008:Hypokalemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed