Onco Wiki / drapeau rouge

Phéochromocytome / chirurgie paraganglioma (adrénalectomie) est planifié ou imminente SANS d...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-PHEO-INADEQUATE-ALPHA-BLOCKADE
TypeSignal d’alerte
Étatreviewed 2026-07-11 | pending_clinical_signoff
MaladiesDIS-PHEOCHROMOCYTOMA
SourcesSRC-ENDOCRINE-SOCIETY-PPGL-2014 SRC-NCCN-NET-2025

Origine du drapeau rouge

DéfinitionPheochromocytoma / paraganglioma surgery (adrenalectomy) is planned or imminent WITHOUT documented adequate preoperative alpha-adrenergic blockade (phenoxybenzamine or doxazosin). Adequate alpha-blockade is mandatory before surgery to prevent an intraoperative hypertensive crisis from catecholamine release during tumor manipulation (Endocrine Society 2014 PPGL guideline). This is a hard sequencing / safety gate, NOT a treatment-selection preference.
Direction cliniqueen attente
Catégorieaptitude physique
Algorithme de décalageALGO-PHEO-1L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "preop_alpha_blockade_adequate",
      "value": false
    },
    {
      "finding": "preop_alpha_blockade_adequate",
      "value": null
    },
    {
      "condition": "Adrenalectomy or paraganglioma resection planned without a documented completed course of preoperative alpha-adrenergic blockade"
    }
  ],
  "type": "clinical_precondition"
}

Notes

Models the narrative's hard requirement that "adequate preoperative alpha-blockade ... is MANDATORY before surgery to prevent intraoperative hypertensive crisis" as an explicit engine-visible safety gate (clinical_direction: hold) rather than free prose. Wired onto IND-PHEO-LOCALIZED-1L-ALPHA-BLOCKADE-ADRENALECTOMY via red_flags_triggering_alternative -- firing this RedFlag means surgery must be HELD, not redirected to a different regimen (the KB schema has no dedicated "required precondition" field on Indication, so red_flags_triggering_alternative is repurposed here for a hold-type gate, consistent with clinical_direction: hold already existing elsewhere in this KB for similar organ-readiness gates, e.g. RF-PDAC-BILIARY-OBSTRUCTION-CHOLANGITIS). No specific numeric duration or target BP/HR threshold is asserted -- "adequate" blockade is intentionally left as a clinical-judgment finding (preop_alpha_blockade_adequate), not an invented number, per CHARTER §8.3. draft:true pending clinical co-lead signoff (CHARTER §6.1, dev-mode-exempted).

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Algorithmes

Maladie

Médicament

Indication

Protocole thérapeutique