VIDEOLAPAROSCOPIC UNILATERAL ADRENALECTOMY - CASE REPORT (Atena Editora)

Abstract

Excessive production of aldosterone by the adrenal cortex is the most common form of systemic arterial hypertension with curative potential. Excess aldosterone increases the risk of vascular events and end-organ damage when comparing patients with this pathology with those whose reason for hypertension is the essential one. Clinical Case: A 50-year-old female patient sought the service of the HUCFF (UFRJ) with a complaint of shortness of breath and difficulty in controlling arterial hypertension, diagnosed 15 years ago. In the last year, a persistent decrease in potassium (2.9 mmol/l) and an increase in serum aldosterone (215 mg/dl. Reference value: 1.8 to 23 mg/dl) were also observed, in addition to worsening congestive heart failure.Planning: A low-density thickening was identified on imaging in the left adrenal topography. Located in the lateral arm of the adrenal gland and measuring 23 mm, the finding was compatible with the hypothesis of adenoma. Preoperative clinical support: Venous diuretic therapy and optimization of other antihypertensive drugs, in addition to maintaining serum potassium levels. Surgical technique: Transperitoneal approach, with the patient in right lateral semi-decubitus position. Difficulty predictor: large number of bands due to previous cholecystectomy and cesarean section. After accessing the left adrenal region and removing the gland, the structure was referred for anatomopathological study. Postoperative period: good evolution, the patient did not need fludrocortisone to compensate for the expected decrease in endogenous corticosteroids.