{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:31Z","timestamp":1756425811408,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,17]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>A 55-year-old man presented with severe right upper quadrant abdominal pain and hypertension up to 231\/171 mm Hg on a background of a known adrenal mass, intravenous drug use and recurrent anxiety attacks. CT showed heterogenous lesion of the right adrenal gland but the sudden severe pain remained unexplained. After correction of the blood pressure with analgesia and antihypertensives, the patient developed a type 2 non-ST-elevation myocardial infarction that was treated with aspirin and therapeutic enoxaparin. This resulted in worsening pain and a repeat CT angiogram showed a haemoretroperitoneum around the right adrenal lesion. On review, an occult intra-adrenal haemorrhage was identified on the initial CT scan. Presumably this concealed haemorrhage caused the initial pain crisis and later decompressed into the retroperitoneal space. Raised metanephrine levels confirmed the diagnosis of pheochromocytoma and after preoperative optimisation with phenoxybenzamine, an open right adrenalectomy was performed.<\/jats:p>","DOI":"10.1136\/bcr-2020-237975","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T18:31:31Z","timestamp":1610476291000},"page":"e237975","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Abdominal pain with intra-adrenal bleeding as an initial presentation of pheochromocytoma"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1742-3734","authenticated-orcid":false,"given":"Astrid","family":"Lambrecht","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-9013","authenticated-orcid":false,"given":"Joshua M","family":"Inglis","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"},{"name":"Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Young","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"},{"name":"Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2025082802140684000_14.1.e237975.1","article-title":"Charalampopoulos a","volume":"53","author":"Farrugia","year":"2019","journal-title":"Pheochromocytoma"},{"key":"2025082802140684000_14.1.e237975.2","doi-asserted-by":"crossref","DOI":"10.1186\/1749-7922-9-50","article-title":"Catastrophic hemorrhage of adrenal pheochromocytoma following thrombolysis for acute myocardial infarction: case report and literature review","volume":"9","author":"Souiki","year":"2014","journal-title":"World J Emerg Surg"},{"doi-asserted-by":"publisher","key":"2025082802140684000_14.1.e237975.3","DOI":"10.1002\/jso.20234"},{"key":"2025082802140684000_14.1.e237975.4","article-title":"The highs and Lows of an unknown pheochromocytoma in an elderly patient","volume":"2019","author":"DiMaria","year":"2019","journal-title":"Case Rep Endocrinol"},{"key":"2025082802140684000_14.1.e237975.5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/j.1751-7176.2009.00073.x","article-title":"Pheochromocytoma presenting with myocardial infarction, cardiomyopathy, renal failure, pulmonary hemorrhage, and cyclic hypotension: case report and review of unusual presentations of pheochromocytoma","volume":"11","author":"Park","year":"2009","journal-title":"J Clin Hypertens"},{"key":"2025082802140684000_14.1.e237975.6","first-page":"573","article-title":"Cardiogenic shock due to acute hemorrhagic necrosis of a pheochromocytoma: a case report and review of the literature","volume":"19","author":"Mohamed","year":"2003","journal-title":"Can J Cardiol"},{"doi-asserted-by":"publisher","key":"2025082802140684000_14.1.e237975.7","DOI":"10.1038\/ncpcardio1054"},{"key":"2025082802140684000_14.1.e237975.8","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1177\/000313480006600804","article-title":"Traumatic hemorrhage of occult pheochromocytoma: a case report and review of the literature","volume":"66","author":"May","year":"2000","journal-title":"Am Surg"},{"doi-asserted-by":"publisher","key":"2025082802140684000_14.1.e237975.9","DOI":"10.1210\/jc.2014-1498"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237975","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:14:15Z","timestamp":1756372455000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,11]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2020-237975"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237975","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}