Nonocclusive mesenteric ischemia associated with propranolol overdose: implications regarding splanchnic circulation.
We describe a case of massive propranolol overdose in a healthy 19-year-old woman associated with isolated mesenteric ischemia following shock. We postulate that endogenous catecholamine release from shock combined with massive beta-adrenergic blockade led to severe splanchnic vasoconstriction from unopposed alpha-adrenergic activity. This case supports current thinking regarding the effect of vasoactive mediators on the gastrointestinal tract in humans and might be relevant to the mechanism of action of propranolol in the prophylaxis of variceal bleeding.
Pettei
M J
MJ
Division of Gastroenterology and Nutrition, Schneider Children's Hospital, New Hyde Park, NY 11042.
Levy
J
J
Abramson
S
S
D000319:Adrenergic beta-Antagonists / Q000506:poisoning; D000328:Adult; D062787:Drug Overdose / Q000503:physiopathology; D004932:Esophageal and Gastric Varices / Q000188:drug therapy; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply / Q000187:drug effects; D007511:Ischemia / Q000139:chemically induced*; D008643:Mesentery / Q000098:blood supply*; D011433:Propranolol / Q000506:poisoning*; D012769:Shock / Q000139:chemically induced*; D013152:Splanchnic Circulation / Q000187:drug effects*; D014661:Vasoconstriction
D000319:Adrenergic beta-Antagonists; D011433:Propranolol