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 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.
deVries
Harry
H
Department of Surgery, University Medical Center Groningen, 30.001, 9700 RB Groningen, The Netherlands. Vriesdeh@dz.nl
Wijffels
Rob T M
RT
Willemse
Pax H B
PH
Verschueren
René C J
RC
Kema
Ido P
IP
Karrenbeld
Arend
A
Prins
Ted R
TR
deVries
Elisabeth G E
EG
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000792:Angiography; D002276:Carcinoid Tumor / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications*; D007082:Ileum / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology*; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D005996:Nitroglycerin; D019518:Postprandial Period
D005996:Nitroglycerin