BÁO CÁO CA LÂM SÀNG ĐA NIỆU SAU PHẪU THUẬT CẮT BỎ U CẬN HẠCH

Abstract

Polyuria after resection of paraganglioma is a rare clinical condition. We report a case of a 78-year-old female patient with a history of hypertension, who was admitted to the hospital for epigastric pain. She was diagnosed with a retroperitoneal mass, and immunohistochemical analysis of the biopsy confirmed the diagnosis of pheochromocytoma, with elevated catecholamine secretion prior to surgery. Preoperative imaging also revealed multiple serous effusions, for which no intervention was indicated. The patient underwent surgical resection of the retroperitoneal tumor. One hour after surgery, she developed significant polyuria accompanied by a rapid decrease in central venous pressure. Her urine output reached 6000 mL within the first 6 postoperative hours. She was treated with intravenous fluid and electrolyte replacement, along with oral administration of 0.1 mg desmopressin, which led to marked improvement in the polyuria. The patient was monitored and discharged on postoperative day 10. This case raises important questions about the underlying mechanisms and appropriate management strategies for this rare postoperative syndrome.