Ultrasound approach in the critically ill patient with pheochromocytoma

Abstract

73-year-old man consulted for chest pain, global headache, nausea, emesis plus diaphoresis and elevated blood pressure for four hours. The patient presented alternating hypertension and hypotension cycles of approximately 11 min, in which he reached systolic blood pressures greater than 300 mm Hg and varied up to systolic blood pressures of 40 mm Hg, without variations in heart rate. In the Emergency Department, an ultrasound scan showed a homogeneous, isoechogenic lesion with defined borders in the left adrenal gland, measuring approximately 4.8 cm x 4.5 cm, a finding that was confirmed
by tomographic study, and which turned out to be a pheochrocytoma. The ultrasound approach (POCUS) in the adrenal glands in the patient with hyperensive crisis usually reveals findings of high diagnostic value, decision making or direction of therapeutic conduct.