Hypertension after Adrenalectomy in a Patient with Aldosterone-producing Adenoma

A 52-year-old patient from Bangladesh, diagnosed with hypertension a year previously, was taking oral antihypertensives. Despite treatment, he still had uncontrolled blood pressure, and no associated symptoms.

The patient was diagnosed with primary aldosteronism, according to lab results. This was concluded by looking at his lab values, which were as follows: Aldosterone: 320 ng/L, Renin: 2.55 ng/L, Potassium: 5.2 mmol/L. The results of the MRI pointed to a left adrenal adenoma. An oblong-shaped focal lesion of 14 x 10.4 x 10.8 mm was found along the maximum TS, AP, and CC dimensions. The inferior section of the left adrenal gland lateral limb was implicated in this lesion, which had low to intermediate signal intensity on all supplied sequences and signal dropout out of the phase sequence. Furthermore, in the post-contrast administration images, there was only minor peripheral contrast augmentation.

This led to a prompt referral to the surgery department where the patient was evaluated and, within a week, operated to successfully remove the tumor.

This report focuses on the assessment, diagnosis, and postoperative care of a patient who came at the hospital with no prior knowledge of the tumor in his adrenal glands. Finally, it details the patient's post-operative symptoms and how they were addressed on the spot to avoid complications. This paper aims to elaborate and enlist in detail the consequences of adrenalectomy in a patient who was previously suffering from an adenoma, but once he was treated for it, he ended up developing hypertension. The aim is to alert both the surgeon and the physician that such consequences could occur in their clinical settings. Only constant evaluation and timely consultations could help prevent such complications.

The reason behind this paper is also to highlight to the physician and the surgeon the complications that could present themselves as unresolved or new chronic conditions in a patient who previously either suffered from them or developed them as a result of their surgery, so that appropriate strategies could be applied to save the patient from such consequences.