Abdominal Angina in Patients with a Midgut Carcinoid, a Sign of Severe Pathology

In 36 consecutive patients with a foregut carcinoid with extensive local tumor growth and liver metastases with a carcinoid syndrome, six patients had complaints of postprandial abdominal pain and attacks of subileus based on segmental intestinal ischemia. A diagnosis of abdominal angina was support...

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Bibliographic Details
Published in:World journal of surgery 2005-09, Vol.29 (9), p.1139-1142
Main Authors: de Vries, Harry, Wijffels, Rob T. M., Willemse, Pax H. B., Verschueren, René C. J., Kema, Ido P., Karrenbeld, Arend, Prins, Ted R., de Vries, Elisabeth G. E.
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Aged
Angiography
Biological and medical sciences
Carcinoid Tumor
Carcinoid Tumor - complications
Cardiology. Vascular system
Coronary heart disease
Fatal Outcome
Female
General aspects
Heart
Humans
Ileal Neoplasms - complications
Ileum - blood supply
Ischemia - etiology
Liver Neoplasms - secondary
Male
Medical sciences
Nitroglycerin
Octreotide
Postprandial Period
Superior Mesenteric Artery
Terminal Ileum
Total Parenteral Nutrition
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Summary:In 36 consecutive patients with a foregut carcinoid with extensive local tumor growth and liver metastases with a carcinoid syndrome, six patients had complaints of postprandial abdominal pain and attacks of subileus based on segmental intestinal ischemia. A diagnosis of abdominal angina was supported by a positive response to nitroglycerin in two and ischemia of the ileum demonstrated by angiography in two other patients. Complaints were reduced in all patients after surgery. Histopathology of the resected small bowel specimens showed elastic vascular sclerosis in three patients and ischemic changes in three other patients, confirming the clinical diagnosis. Resection of ischemic bowel can provide relief in patients with segmental intestinal ischemia caused by carcinoid‐induced vascular sclerosis.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-005-7825-x