2021 Volume 28 Issue 6 Pages 537-541
A 22-year-old woman was referred to our hospital with intratumoral hemorrhage in a left adrenal tumor, severe shock, and loss of consciousness. In the differential diagnosis, we considered various diseases that cause shock, and simultaneously carried out systemic management, including massive intravenous fluid replacement, continuous administration of catecholamines via infusion pumps, artificial respiration, and steroid replacement. The patient’s condition stabilized within a few days. However, we suspected hypertensive crisis that was possibly attributable to a pheochromocytoma because of the rapid increases in blood pressure upon mild stimulation and initiated α- and β-blocker treatment. After a retroperitoneoscopic adrenalectomy, the patient was discharged uneventfully on the 62 nd of admission. Pheochromocytoma multisystem crisis is a very rare disease; however, intensivists need to understand its pathogenesis because of the high mortality rate of this endocrine disease. Furthermore, it is important to understand and appropriately manage the patient’s continually changing clinical condition while monitoring vital signs to make an accurate diagnosis.
