2013 Volume 33 Issue 1 Pages 161-165
We describe herein an adrenal pheochromocytoma that spontaneously ruptured and caused abdominal compartment syndrome (ACS) with the subsequent death of the patient. Spontaneous rupture of a pheochromocytoma is extremely rare, moreover, the prognosis can be very poor. A 49-year-old man arrived at our hospital by ambulance with sudden severe abdominal pain. Abdominal contrast-enhanced CT imaging revealed a hemorrhaging left adrenal mass surrounded by a massive hematoma. Cannulation during angiography for embolization destabilized the patient's blood pressure. We suspected a pheochromocytoma and proceeded conservatively because intravascular embolization is contraindicated for this condition. However, hypovolemic shock had developed and CT imaging indicated continuous bleeding and ACS. Intravascular embolization was followed by the surgical arrest of bleeding and abdominal decompression. Despite adjunctive post-operative therapeutic modalities such as continuous hemodiafiltration, the patient died of multiple organ failure on the 6th postoperative day.
