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Postgrad Med J. 1989 August; 65(766): 594–596.
PMCID: PMC2429508

Intestinal ischaemia associated with phaeochromocytoma.

Abstract

The present case report describes a patient with an adrenal phaeochromocytoma who presented with infarction of the small intestine. The clinical features, diagnosis and treatment of this case are described. Despite excision of the tumour and necrotic intestine, this patient died in the postoperative period from overwhelming sepsis and multi-organ failure. Special reference is made to the delayed effects of established intestinal ischaemia on immune function and it is suggested that this was major contributory factor to the fatal outcome in the present case. The onset of gastro-intestinal symptoms in patients with phaeochromocytoma should suggest the possibility of imminent gut ischaemia and indicate the necessity for prompt excision of the tumour.

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Selected References

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  • GIFFORD RW, Jr, KVALE WF, MAHER FT, ROTH GM, PRIESTLEY JT. CLINICAL FEATURES, DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMA: A REVIEW OF 76 CASES. Mayo Clin Proc. 1964 Apr;39:281–302. [PubMed]
  • Bravo EL, Gifford RW., Jr Current concepts. Pheochromocytoma: diagnosis, localization and management. N Engl J Med. 1984 Nov 15;311(20):1298–1303. [PubMed]
  • Baker G, Zeller NH, Weitzner S, Leach JK. Pheochromocytoma without hypertension presenting as cardiomyopathy. Am Heart J. 1972 May;83(5):688–693. [PubMed]
  • Melicow MM. One hundred cases of pheochromocytoma (107 tumors) at the Columbia-Presbyterian Medical Center, 1926-1976: a clinicopathological analysis. Cancer. 1977 Nov;40(5):1987–2004. [PubMed]
  • ROSCH PJ. Gastrointestinal bleeding in pheochromocytoma and following the administration of norepinephrine (arterenol). AMA Arch Intern Med. 1959 Aug;104(2):175–179. [PubMed]
  • Fee HJ, Fonkalsrud EW, Ament ME, Bergstein J. Enterocolitis with peritonitis in a child with pheochromocytoma. Ann Surg. 1977 Apr;185(4):448–450. [PubMed]
  • Rosati LA, Augur NA., Jr Ischemic enterocolitis in pheochromocytoma. Gastroenterology. 1971 Apr;60(4):581–585. [PubMed]
  • BROWN RB, BOROWSKY M. Further observations on intestinal lesions associated with pheochromocytomas. A case of malignant pheochromocytoma in pregnancy. Ann Surg. 1960 May;151:683–692. [PubMed]
  • Morris K, McDevitt B. Phaeochromocytoma presenting as a case of mesenteric vascular occlusion. Ir Med J. 1985 Dec;78(12):356–357. [PubMed]
  • Cruz SR, Colwell JA. Pheochromocytoma and ileus. JAMA. 1972 Feb 21;219(8):1050–1051. [PubMed]
  • BROWN RB, RICE BH, SZAKACS JE. Intestinal bleeding and perforation complicating treatment with vasconstrictors. Ann Surg. 1959 Nov;150:790–798. [PubMed]
  • CUNNINGHAM GJ. Intestinal lesions in malignant hypertension with report of a case. Br Med J. 1948 Jun 5;1(4561):1075–1077. [PMC free article] [PubMed]
  • LOBER PH, LILLEHEI W. Necrotizing panarteritis following repair of coarctation of aorta; report of two cases. Surgery. 1954 Jun;35(6):950–956. [PubMed]
  • Tracey KJ, Lowry SF, Fahey TJ, 3rd, Albert JD, Fong Y, Hesse D, Beutler B, Manogue KR, Calvano S, Wei H, et al. Cachectin/tumor necrosis factor induces lethal shock and stress hormone responses in the dog. Surg Gynecol Obstet. 1987 May;164(5):415–422. [PubMed]
  • Beutler B, Milsark IW, Cerami AC. Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin. Science. 1985 Aug 30;229(4716):869–871. [PubMed]
  • Fink MP, Gardiner WM, Roethel R, Fletcher JR. Plasma levels of 6-keto PGF1 alpha but not TxB2 increase in rats with peritonitis due to cecal ligation. Circ Shock. 1985;16(3):297–305. [PubMed]
  • Fiddian-Green RG. Splanchnic ischaemia and multiple organ failure in the critically ill. Ann R Coll Surg Engl. 1988 May;70(3):128–134. [PMC free article] [PubMed]
  • Fiddian-Green RG, Amelin PM, Herrmann JB, Arous E, Cutler BS, Schiedler M, Wheeler HB, Baker S. Prediction of the development of sigmoid ischemia on the day of aortic operations. Indirect measurements of intramural pH in the colon. Arch Surg. 1986 Jun;121(6):654–660. [PubMed]
  • Fiddian-Green RG, Gantz NM. Transient episodes of sigmoid ischemia and their relation to infection from intestinal organisms after abdominal aortic operations. Crit Care Med. 1987 Sep;15(9):835–839. [PubMed]
  • Jones DJ, Durning P. Phaeochromocytoma presenting as an acute abdomen: report of two cases. Br Med J (Clin Res Ed) 1985 Nov 2;291(6504):1267–1268. [PMC free article] [PubMed]

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