After surgical removal of a pheochromocytoma, which complication is most likely in the immediate postoperative period?

• A. Hypotension
• B. Hypertension
• C. Hyperglycemia
• D. Hyperkalemia

Answer: (A)

After removing a pheochromocytoma, the body loses the sudden source of excess catecholamines that kept vessels constricted and blood pressure high. The preoperative alpha-blockade and planned fluid management mean the vessels are relatively vasodilated and the circulating volume may be depleted. This combination commonly causes a drop in blood pressure in the immediate postoperative period, making hypotension the most likely complication right after surgery. Fluids and, if needed, vasopressors are used to support perfusion during this time. Hypertension is unlikely once the catecholamine source is gone, and while glucose and electrolytes can fluctuate, they are not the primary immediate postoperative concern in this scenario.