Pheochromocytoma Presenting as an Abdominal Emergency: Association with Perforation of the Colon

Abstract

A pheochromocytoma is a rare tumor derived from the adrenal medulla (or from chromaffin cells of sympathetic ganglia). Its symptoms derive mostly from the excessive release of catecholamines (adrenaline and noradrenaline). Hypertension is the most recognized feature of this disease, but gastrointestinal manifestations can on rare occasions be just as serious and life threatening. This report describes a rare case of a 70-year-old woman with pheochromocytoma who developed an acute abdominal emergency with shock and panperitonitis as a result of perforation of the descending colon which was effectively treated by surgical removal of the tumor and the perforated colon. There have been 2 such cases in the English literature in whom a pheochromocytoma was associated with perforation of the colon. Successful surgical removal of such a pheochromocytoma has been not reported previously. Our case demonstrates the importance of recognizing that a pheochromocytoma presents with a wide spectrum of manifestations, and rapid treatment brings improvement to the patient.

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

“…The latter may be complicated by enterocolitis [98,99], volvulus or colonic rupture [100], and fecal peritonitis [101]. Other abdominal emergencies in patients who have pheochromocytoma include acute cholecystitis [102,103], acute pancreatitis [104], and ruptured aneurysm of the abdominal aorta [82].…”