Post-operative refractory hypotension and diuresis in a case of bilateral pheochromocytoma

Pheochromocytomas are relatively uncommon tumors, with prevalence of 0.3-0.95% in autopsy series. Patients with pheochromocytomas have a potentially curable cause of hypertension. Following surgical removal of pheochromocytoma 80% of patients are expected to become normotensive. Persistent post-operative hypertension may be due to residual tumor, metastatic disease or intra-operative injury to the renal artery or the kidney. Around 20% of patients will remain hypertensive without biochemical evidence of residual tumor; however, due to associated essential hypertension or due to acquired renovascular changes. We present a rare case of refractory hypotension in a post-operative case of bilateral pheochromocytoma.