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.