Postoperative fatal intestinal necrosis after enalapril treatment in a patient with rheumatoid arthritis.
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.
Schweizer
A
A
Division of Anesthesiology, University Hospital, Geneva, Switzerland.
Hohn
L
L
Morel
D R
DR
Spiliopoulos
A
A
Licker
M
M
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
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004656:Enalapril