HYPERTENSIVE CRISIS IN POSTOPERATIVE CASE OF WILMS TUMOUR-AN
UNUSUAL CASE
Abstract :
Wilms Tumour also known as nephroblastoma,is a highly malignant
embryonal neoplasm,involving one or both kidney. It affects children
between 3 to 5 years of age and unilateral but 5% cases bilateral.
Disease occur in about 1 out of 2-2.5 lakh children. Hypertension is
noted in children with wilms tumour either at the time of initial
presentation or in the post operative period due to increase renin
secretion. We report a case of postoperative hypertension in a case of
wilms tumour. The complexity of anaesthesia was determined by the size
of the tumour ,increased intra abdominal pressure & hypertension.
Key words:Wilms Tumour,Hypertension.
Introduction :
Wilms Tumour also known as nephroblastoma, is a highly malignant
embryonal neoplasm,involving one or both kidney. It affects children
between 3 to 5 years of age and tumour is unilateral,but in 5% cases
bilateral. Disease occur in about 1 out of 2-2.5 lakh children. Due to
increase renin secretion hypertension can be detected in children with
wilms tumour either at the time of initial presentation or in the post
operative period and symptoms may include abnormally large abdomen,
fever, nausea, vomiting, hypertension, tachycardia, and tachypnea.
Diagnostic evaluation includes ultrasound, computed tomography (CT)
scans, complete blood count (CBC),urinalysis, and coagulation tests.
Treatment consists of multimodal treatment with subsequent
surgery1-2.
Anaesthesia management is challenging as large size of wilms tumour
(12.9*10*11),hypertension,blood loss and anemia. The challenging part of
our care was postoperative hypertensive crisis and it was managed
successfully.