• A&A practice · May 2019

    Case Reports

    Perioperative Hypertensive Urgency After Methylene Blue in a Patient With Undiagnosed Pheochromocytoma: A Case Report.

    • Shikha Shukla, Richard Zhu, Philip Rubin, and Ranjit Deshpande.
    • From the Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut.
    • A A Pract. 2019 May 1; 12 (9): 321-324.

    AbstractWe report the perioperative course of a 75-year-old woman undergoing robotic-assisted laparoscopic hysterectomy and tumor debulking. The patient developed severe, persistent hypertension after intraoperative methylene blue administration requiring a Surgical Intensive Care Unit admission with further investigative evaluation revealing a previously undiagnosed pheochromocytoma. Our discussion focuses on the differential diagnoses for her perioperative hypertension. We evaluate whether methylene blue triggered a pheochromocytoma crisis in our patient and emphasize the caution and critical thinking we all should demonstrate while providing anesthetic care.

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