Any patient with grossly exaggerated and unexplained hypertension and tachycardia during anaesthesia needs to be followed up and investigated for pheochromocytoma. Drugs must be available in all the anaesthetic sites and all the anaesthetists must be familiar of their uses. References 1. O’Riordan JA: Pheochromocytomas and anesthesia. Int find more Anesthesiol Clin 1997, 35:99–127.CrossRefPubMed 2. Tarant NS, Dacanay RG, Mecklenburg BW, Birmingham SD, Lujan E: Acute appendicitis in a patient with undiagnosed pheochromocytoma. Anesth Analg 2006, 102:642–3.CrossRefPubMed 3. Dabbous A, Siddik-Sayyid S, Baraka A: Catastrophic hemodynamic changes in A patient with undiagnosed pheochromocytoma undergoing abdominal hysterectomy. Anesth Analg 2007, 104:223–4.CrossRefPubMed

4. Lewis S, Dirnhuber M, Soar J: An unusual presentation

of a pheochromocytoma. J Cardiothorac Vasc Anesth 2006, 20:390–393.CrossRefPubMed 5. Holldack HJ: Induction of Anesthesia Triggers Hypertensive Crisis in a Patient With Undiagnosed Pheochromocytoma: Could Rocuronium be to Blame? J Cardiothorac Vasc Anesth 2007, 21:858–62.CrossRefPubMed 6. Plouin PF, Duclos JM, Soppelsa F, Boublil G, Chatellier G: Factors associated with perioperative morbidity and mortality in patients with pheochromocytoma: analysis of 165 operations at a single center. J Clin Endocrinol Metab 2001, 86:1480–6.CrossRefPubMed 7. Myklejord DJ: eFT508 chemical structure Undiagnosed pheochromocytoma: The anaesthesiologist nightmare. Clin Med Res 2004, 2:59–62.CrossRefPubMed 8. Prys-Roberts C: Phaeochromocytoma-recent progress in its management. Br J Anaesth 2000, 85:44–57.CrossRefPubMed 9. James MFN: Use of magnesium sulphate in the anaesthetic Selleckchem ATM Kinase Inhibitor management of phaeochromocytoma: A review of 17 anaesthetics. Br J Anaesth 1989, 62:616–623.CrossRefPubMed Competing interests The authors declare that they have no competing interests.”
“Background Intestinal obstruction is a common surgical emergency caused by varied conditions. Appendix as a cause of intestinal obstruction is uncommon and not usually suspected.

Although it was described as early as 1901, very few reports are available which do a comprehensive review [1]. Buspirone HCl Intestinal strangulation caused by appendix is extremely rare with very few cases reported. Pre-operatively it is very difficult to diagnose this condition. The diagnosis is always made at the time of laparotomy. The treatment varies from appendicectomy to intestinal resection or even right hemicolectomy. We are reporting a case of intestinal strangulation caused by appendicitis, for which appendicectomy was done. This is a very rare complication of an extremely common disease. We reviewed the literature to find out about appendix producing intestinal obstruction in general and intestinal strangulation in particular. We have included a comprehensive discussion about appendicitis producing intestinal obstruction with regards to its various pathological types, different clinical presentations, diagnosis and management.