An unusual diagnosis for persistent diarrhoea and vomiting.
Identifying the etiology of chronic diarrhoea might be challenging in some patients, and before a diagnosis is made these patients may spend a substantial length of time with unresolved symptoms leading to uncertainty and anxiety that is severely impairing their life quality. A 45-year-old female was referred by her general practitioner with a 5-year history of increasingly frequent episodes of cyclical diarrhoea, vomiting, abdominal pain and intermittent palpitations. Contrast CT Abdomen/Pelvis revealed a 36x33x46 mm mass in the aorto caval region of her retro-peritoneum, just above the bifurcation.  On the basis of her symptoms, CT findings and an elevated plasma metanephrine level of 2314pmol/L (normal range 80 - 510pmol/L), it was at this point a likely diagnosis of a phaeochromocytoma was made. The retroperitoneal mass was successfully resected, and the histology confirmed a Phaeochromocytoma. Her symptoms rapidly improved and she made a good recovery. This unusual case highlights some of the dilemmas that arise when investigating patients with chronic and recurrent diarrhoea and vomiting.
Department of Gastroenterology, Milton Keynes University Hospital, Milton Keynes, UK. 2016.
James
J
Nott
Department of Gastroenterology, Milton Keynes University Hospital, Milton Keynes, UK. 2016.
Asad
A
Khan
Department of Gastroenterology, Milton Keynes University Hospital, Milton Keynes, UK. 2016.
Ravi
R
Madhotra
Department of Gastroenterology, Milton Keynes University Hospital, Milton Keynes, UK. 2016.
George
G
MacFaul
Department of Gastroenterology, Milton Keynes University Hospital, Milton Keynes, UK. 2016.
Kamran
K
Rostami