RT Journal Article SR Electronic T1 Lesson of the month 2: Blunt abdominal trauma: atypical presentation of phaeochromocytoma JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 345 OP 347 DO 10.7861/clinmedicine.18-4-345 VO 18 IS 4 A1 Sarah Faloon A1 Hema Venkataraman A1 Kassiani Skordilis A1 Ewen A Griffiths A1 Neil JL Gittoes A1 Zaki K Hassan-Smith A1 John Ayuk YR 2018 UL http://www.rcpjournals.org/content/18/4/345.abstract AB A 26-year-old man presented following blunt abdominal trauma to a regional major trauma centre for emergency embolisation of a retroperitoneal bleed from a presumed renal laceration. Imaging had also revealed a large right suprarenal mass. Embolisation resulted in a hypertensive crisis raising the suspicion of a metabolically active adrenal tumour. The course was further complicated by the development of ischaemic bowel requiring emergency laparotomy. Intraoperatively he became haemodynamically unstable from an actively haemorrhaging lesion. Emergency laparotomy and adrenalectomy was performed as a life-saving procedure. Histology confirmed a phaeochromocytoma. The patient made a gradual recovery and was discharged home with no sequelae. Definitive management of phaeochromocytoma is surgical resection which requires prolonged preoperative optimisation with alpha receptor blockers to adequately control blood pressure and prevent hypertensive crises. Parenteral alpha receptor blockers, such as phentolamine, are optimal treatment for intraoperative hypertensive emergencies, yet they are currently not available in the UK.