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Updated: Jun 20, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis
Florence Tan1, Ah Chuan Thai, Wei Keat Cheah
1Department of Medicine, Sarawak General Hospital, Malaysia; and Departments of Medicine and Surgery, National University Hospital, Singapore. ftanhs@yahoo.co.uk
Abstract:
A 45-year-old woman with poorly controlled hypertension and diabetes mellitus presented with left iliac fossa pain, constipation alternating with diarrhea, and weight loss. She had been diagnosed with idiopathic cardiomyopathy five years previously. Echocardiogram had shown a left ventricular ejection fraction (LVEF) of 35%; coronary angiogram was normal. Colonoscopy revealed sigmoid colitis with stenosis. Abdominal computed tomography revealed a 5 cm right adrenal tumor. Twenty-four hour urinary free catecholamines and fractionated metanephrine excretion values were elevated, confirming pheochromocytoma. Her colitis resolved after one month of adrenergic blockade. Repeat echocardiogram showed improvement of LVEF to 65%. After laparoscopic right adrenalectomy, the patient's hypertension resolved, and diabetic control improved. Timely management avoided further morbidity and potential mortality in our patient.
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