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A case of ruptured pheochromocytoma causing loss of life of a patient due to delay in diagnosis

Ruptured pheochromocytoma is an unusual condition, with a mortality rate reaching 31–50%. We describe a case of ruptured pheochromocytoma that was initially mistaken for acute inferior myocardial infarction. On computed tomography, a hemorrhagic mass surrounding the kidney in the region of the right adrenal was observed, but its origin could not clearly be distinguished. On laparotomy, a ruptured and hemorrhagic mass with common necrotic areas was seen, and this was excised successfully. After surgery, the patient experienced a sudden drop in blood pressure. In the postoperative period in the intensive care unit, cardiac arrest occurred. The patient could not be saved. The histological evaluation of the mass showed that it was pheochromocytoma. A surgery combined with early diagnosis and appropriate preoperative treatment may be life-saving. We think that this phenomenon is reminiscent of the adage that an “acute abdomen is filled with surprises”.