Phaeochromocytomas may present as an acute emergency with a perplexing variety of symptoms. We report a case which presented with abdominal pain and severe respiratory distress due to a ruptured haemorrhagic phaeochromocytoma. The severe cardiorespiratory collapse which precipitated admission to the intensive care unit was managed with high doses of dobutamine and noradrenaline and the patient was stable during the operative resection. The management of this previously undiagnosed phaeochromocytoma and its atypical presentation are discussed.
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