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Details for article 12 of 14 found articles
| Title: |
Previously clinically “silent” adrenal phaeochromocytoma presenting as hypovolemic shock with paradoxical hypertension |
| Author: |
Rashid SH Youssef H Ali AA Apakama IG |
| Appeared in: |
Libyan journal of medicine |
| Paging: | Volume 2 (2007) nr. 3 pages AOP:070606 |
| Year: |
2007 |
| Contents: |
CASE PRESENTATIONA 58-year-old male patient presented to the Emergency Department with a 6-8 hour history of left upper quadrant pain associated with general malaise, dizziness, nausea and vomiting. There were no other gastrointestinal or genitourinary symptoms; in particular the patient denied any evidence of gastrointestinal bleeding. He had a past medical history of hypertension, which was being treated with lisinopril. On examination, the patient appeared unwell. He was fully alert but anxious with a Glasgow Coma Score (GCS) of 15. He was tachypnoeic (respiratory rate 25/min) with normal oxygen saturations (98%, FiO2 0.21) and temperature (36°C). He was sweaty with a tachycardia (heart rate 140 bpm) and prolonged capillary refill time (>5 seconds). The patient was also very hypertensive (BP 220/120 mmHg), but the rest of the cardiovascular and respiratory examination was normal. Abdominal examination demonstrated tenderness with guarding over the left upper quadrant and normal bowel sounds. There were no palpable masses. Blood tests showed a leucocytosis (27.54 x 106) with a neutrophilia (24.97 x 106), normal haemoglobin (14.9g/dL) and platelet count (445,000/L). The urea and creatinine were raised (9.6mmol/L and 160mmol/L respectively). He also had an elevated alkaline phosphatase (249mmol/L), alanine aspartase (41nmol/L) and C-reactive protein (9nmol/L). He was also hyperglycaemic (random glucose 12.6mmol/L). A chest radiograph showed an elevated left hemi-diaphragm. A computed tomography (CT) scan of the abdomen revealed a left peri-renal collection consistent with a haematoma and left adrenal mass measuring 12cm in diameter (see Figure 1). Also of note was a large left pleural effusion and moderate right pleural effusion. |
| Publisher: |
Ibnosina Medical Association and Alfatah University, Faculty of Medicin, Tripoli |
| Source file: |
Elektronische Wetenschappelijke Tijdschriften |
Details for article 12 of 14 found articles
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