title: Postoperative fatal intestinal necrosis after enalapril treatment in a patient with rheumatoid arthritis.
abstract: The inappropriate use of antihypertensive medications may cause hypotensive responses associated with organ failure. We describe a patient who developed nonocclusive splanchnic ischemia leading to death following the administration of enalapril to treat postoperative hypertension. The mechanisms and consequences of refractory hypotension induced by angiotensin-converting enzyme inhibitors are discussed.
authors.affiliation: Division of Anesthesiology, University Hospital, Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Schweizer
authors.forename: L
authors.initials: L
authors.lastname: Hohn
authors.forename: D R
authors.initials: DR
authors.lastname: Morel
authors.forename: A
authors.initials: A
authors.lastname: Spiliopoulos
authors.forename: M
authors.initials: M
authors.lastname: Licker
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D003106:Colon / Q000098:blood supply*; D004656:Enalapril / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007511:Ischemia / Q000139:chemically induced*; D009102:Multiple Organ Failure / Q000139:chemically induced; D009336:Necrosis; D011183:Postoperative Complications / Q000139:chemically induced* / Q000188:drug therapy; D013152:Splanchnic Circulation / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004656:Enalapril