Intra-operative haemodynamic volatility in a patient undergoing retroperitoneal cyst excision.
Excision of a suspected retroperitoneal, duodenal duplication cyst was performed in a pre-operatively normotensive patient under combined epidural and general anaesthesia. Intraoperatively, the cystic tumour was discovered to be a retroperitoneal mass, free from duodenal or adrenal origin. Development of severe arrhythmias, ST segment changes and hypertensive spikes during cyst handling and dissection suggested the possibility of a catecholamine-secreting tumour. These were managed effectively with pharmacological agents. Subsequently, histopathology of the specimen revealed a paraganglioma. Vasoactive tumour has to be suspected in every patient undergoing anaesthesia for retroperitoneal cystic lesion.
Department of Anaesthesiology, A J Institute of Medical Sciences, Kuntikana, Mangalore, Karnataka, India.
Thrivikrama Padur
TP
Tantry
Sunil P
SP
Shenoy
Pramal
P
Shetty
Karunakara K
KK
Adappa