Anaesthetic management for pheochromocytoma resection in a 5-year-old boy with cerebral haemorrhage and intestinal obstruction

Pheochromocytoma is rarely seen under the age of 8 years and the anaesthesia for pheochromocytoma surgery is challenging. We present the perioperative management of a 5-year-old boy with intestinal obstruction and two episodes of cerebral haemorrhage who presented for pheochromocytoma resection and enterolysis. Important issues in the management of this patient included choice of vasoactive agents and anaesthetics, control of blood pressure and intracranial pressure, preioperative fluid management, and monitoring technique. Imbalance of fluid and electrolyte disturbance as well as a potentially inevitable drop in blood pressures after complete excision of tumour further complicate patient care. Knowledge of different medical issues involved in this case and their potential impact on anaesthetic management is paramount for safe perioperative patient care.