Bowel perforation as a presenting feature of pheochromocytoma: case report and literature review.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Vasu KarriYvonne Wilson

Abstract

To report a case of colonic perforation as the initial manifestation of pheochromocytoma and discuss the underlying pathophysiologic mechanism. The clinical, biochemical, radiologic, and pathologic findings are described. In addition, the management of the patient is discussed and the relevant literature reviewed. A 57-year-old man presented with large bowel perforation after pseudo-obstruction. Emergency laparotomy revealed two cecal perforations but no obstructing lesion; however, hypertension persisting postoperatively raised the suspicion of pheochromocytoma. This diagnosis was confirmed by measurement of 24-hour urinary hydroxymethylmandelic acid excretion and computed tomography of the abdomen. The tumor was subsequently resected without complication or recurrence of bowel symptoms. The pathophysiology of bowel perforation in patients with pheochromocytoma is not entirely clear but most likely involves bowel ischemia and necrosis as a result of mesenteric vasoconstriction. This setting coupled with increased intraluminal pressure as a consequence of pseudo-obstruction may cause perforation. Bowel perforation in patients with pheochromocytoma is rare and thought to be a consequence of intestinal ischemia and altered motili...Continue Reading

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Citations

Sep 10, 2009·Southern Medical Journal·Florence TanJ J Mukherjee
Jun 9, 2009·Journal of Pain and Symptom Management·Louise D MasonBenjamin C Whitelaw
Nov 28, 2006·Endocrinology and Metabolism Clinics of North America·Frederieke M BrouwersKarel Pacak
Sep 21, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Sophie Ignace-GirerdEmmanuel Villar
Oct 10, 2013·Clinical Endocrinology·B C WhitelawS J B Aylwin
Jun 11, 2015·European Journal of Endocrinology·Sonali ThosaniCamilo Jimenez
Mar 27, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Sanjeet Kumar JaiswalNalini S Shah
Mar 24, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Garima GuptaUNKNOWN AACE Adrenal Scientific Committee
Feb 17, 2017·Endocrinology, Diabetes & Metabolism Case Reports·Elise FlynnEgo Seeman

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