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Incidence of blunt hollow viscus injuries is low in children. Hematomas are easily recognized by modern radiography, and simply managed nonoperatively. Diagnosis of perforations still remains difficult. This results in dangerous delays for lesions which need prompt repair.

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Key wordsC'n~~ii)/ic.citioiis; hypoglycaemic encephalopathy. S~i r g c q~; p haeoch ro niocy t oina reinova I.Many coinplications that follow surgery on phaeochromocytoma have been reported and mainly concern bleeding. haemodynamic disturbances. cardiac dysrhythmias and fluid balance problems. Phaeochromocytoma is also associated with a diabetic syndrome that presents with hyperglycaemia both pre-and postoperatively.However, some patients may develop hypoglycaemia d uring surgery and immediately postoperatively, due to a rebound insulin storm as ;I result of inhibition of catecholaminc secretion following removal of the timiour. Here we describe a case of hypoglycaemic eneephalopathy that resulted from hypoglycaemia o f nearly 4 hours' duration. which subsequently resolved without sequelae. Case historyAn 18-year-old Saudi male presented with intermittent attacks of severe headache, dizziness, palpitations and sweating that occurred over a period or 12 months. Blood pressure measurement during one such episode revealed severe hypertension and he was referred to King Khalid Hospital with a provisional diagnosis of phacochroniocytoma.On examination he was a healthy young man o f normal intelligence and behaviour. General and systematic examination revcaled n o abnormality. He remained normotensive apart from ~w o brief elevations of arterial blood prcssurc to 170.'90 mniHg.A series of 24-hour urine samples showed elevation of vanillyl mandclic acid to thrcc times the normal level. Ultrasonography and CT scan revealed a k n i inass in the right adrenal gland. The left adrenal was normal in size and shape. A diagnosis of phaeochromoeytoma of the right adrenal gland was made and he was prepared for surgery with a 4-day course of phcnoxy-

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