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  Vol. 123 No. 5, May 1988 TABLE OF CONTENTS
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  PAPERS READ BEFORE THE 68TH ANNUAL MEETING OF THE NEW ENGLAND SURGICAL SOCIETY, BRETTON WOODS, NH, SEPT 11 TO SEPT 13, 1987
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Advances in the Diagnosis and Treatment of Pheochromocytoma

Robert J. Havlik, MD; C. Elton Cahow, MD; Barbara K. Kinder, MD

Arch Surg. 1988;123(5):626-630.


Abstract

• Diagnosis and management of pheochromocytoma, once dangerous and uncertain, have been dramatically altered in recent years by advances in imaging, assays, and pharmaceuticals. During the past ten years we have treated 18 patients who had pheochromocytoma. Biochemical diagnosis was made In all patients by measurement of 24-hour urinary total catecholamine excretion or by epinephrine-norepinephrine fractionation. Determination of epinephrine-norepinephrine ratios was instrumental in making the diagnosis of pheochromocytoma in two patients in whom total catecholamine levels were normal. Localization of the pheochromocytoma in the most recently treated cases was accomplished by ultrasound, computed tomography, or iodine I 131 iobenguane (iodine I 131 metaiodobenzylguanidine) scanning. Nine patients in the series were prepared for surgery with phenoxybenzamine hydrochloride and six with prazosin hydrochloride. Preoperative total {alpha}-adrenergic blockade with phenoxybenzamine offered no advantage over selective blockade with prazosin in terms of perioperative fluid requirements or intraoperative hemodynamlc stability.

(Arch Surg 1988;123:626-630)



Author Affiliations

From the Department of Surgery, Yale University School of Medicine, New Haven, Conn.


Footnotes

Accepted for publication Jan 29, 1988.

Read before the Annual Meeting of the New England Surgical Society, Bretton Woods, NH, Sept 12, 1987.

Reprint requests to Department of Surgery, Yale University School of Medicine, 333 Cedar St, PO Box 3333, New Haven, CT 06510-8062 (Dr Kinder).



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Sensitivity of Diagnostic and Localization Tests for Pheochromocytoma in Clinical Practice
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Arch Intern Med 2000;160:2521-2524.
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