Hypertensive crisis inducing rhabdomyolysis during laparoscopic resection of a large pheochromocytoma: a case report.
Intense vasospasm during hypertensive crisis as a cause for rhabdomyolysis has been described in ambulatory patients with pheochromocytoma. We report this phenomenon as an intraoperative complication in a patient during laparoscopic pheochromocytoma resection and discuss patient and procedure related risk factors. Unexplained intraoperative hyperkalemia following a severe hypertensive episode during surgery may be a first sign of rhabdomyolysis. Anesthesiologists should be aware of such a possibility. Intra- and postoperative serial electrolyte determinations and if suspected, timely screening for myoglobiuria, may aid in early detection and treatment of intraoperative rhabdomyolysis during pheochromocytoma resections.
Schumann
Roman
R
Department of Anesthesia, Tufts University School of Medicine 02111, Boston, MA, USA. Rschumann@tufts-nemc.org
Joseph
Nandini
N
Zabala
Luis
L
Schwaitzberg
Steven D
SD
Lechan
Ronald M
RM
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000328:Adult; D004562:Electrocardiography; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D010535:Laparoscopy; D008297:Male; D016343:Monitoring, Intraoperative; D009765:Obesity / Q000150:complications; D010673:Pheochromocytoma / Q000601:surgery*; D012206:Rhabdomyolysis / Q000209:etiology*; D014057:Tomography, X-Ray Computed