title: The treatment of pheochromocytoma associated with pseudo-obstruction and perforation of the colon, hepatic failure, and DIC.
abstract: The case of a 59-year-old man with paralytic ileus (pseudo-obstruction) associated with pheochromocytoma is reviewed. Paralytic ileus is believed to have been the result of overstimulation of alpha and beta receptors on the intestine by catecholamines. Phentolamine, bunazocin, propranolol, bethanechol and midaglizole in single administrations or in combination were administered. Phentolamine infusion clearly relieved the symptom, but ileus recurred, and the patient died of respiratory failure, liver dysfunction and disseminated intravascular coagulation syndrome. The significant role of catecholamines in causing these symptoms is discussed, and the management of this relatively rare complication is reviewed.
authors.affiliation: Department of Metabolic Medicine, Kumamoto University Medical School, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: S
authors.initials: S
authors.lastname: Motoyoshi
authors.forename: H
authors.initials: H
authors.lastname: Maruyama
authors.forename: M
authors.initials: M
authors.lastname: Sakakida
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: K
authors.initials: K
authors.lastname: Goto
authors.forename: S
authors.initials: S
authors.lastname: Sugihara
authors.forename: S
authors.initials: S
authors.lastname: Takano
authors.forename: T
authors.initials: T
authors.lastname: Kambara
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D018723:Bethanechol; D001626:Bethanechol Compounds / Q000627:therapeutic use; D002395:Catecholamines / Q000502:physiology; D056486:Chemical and Drug Induced Liver Injury; D003112:Colonic Pseudo-Obstruction / Q000150:complications* / Q000188:drug therapy; D003606:Dacarbazine / Q000009:adverse effects; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D004298:Dopamine / Q000652:urine; D004338:Drug Combinations; D004837:Epinephrine / Q000097:blood / Q000652:urine; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007416:Intestinal Perforation / Q000150:complications* / Q000601:surgery; D008107:Liver Diseases / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood / Q000652:urine; D010646:Phentolamine / Q000627:therapeutic use*; D010673:Pheochromocytoma / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D011433:Propranolol / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D011860:Radiography, Abdominal
chemical_list: D000317:Adrenergic alpha-Antagonists; D001626:Bethanechol Compounds; D002395:Catecholamines; D004338:Drug Combinations; D007093:Imidazoles; D011799:Quinazolines; D018723:Bethanechol; C032368:midaglizole; D003606:Dacarbazine; C018176:bunazosin; D011433:Propranolol; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine; D010646:Phentolamine