Skip to main content
Log in

Abdominal Angina in Patients with a Midgut Carcinoid, a Sign of Severe Pathology

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Modlin IM, Sandor A . An analysis of 8305 cases of carcinoid tumors. Cancer 1997;79:813–829

    Article  PubMed  Google Scholar 

  2. Neary PC, Redmond PH, Houghton T, et al. Carcinoid disease: review of the literature. Dis. Colon Rectum 1997;40:349–362

    Article  PubMed  Google Scholar 

  3. Moertel CG, Sauer WG, Dockerty MB, et al. Life history of the carcinoid in the small intestine. Cancer 1961;14:901–912

    PubMed  Google Scholar 

  4. Anthony PP, Drury RA. Elastic vascular sclerosis of mesenteric blood vessels in argentaffin carcinoma J. Clin Pathol. 1970;23:110–118

    Google Scholar 

  5. Brada SJ, Wijffels RT, Kahraman T, et al. Sublingual nitrate provides cause for fear of food in a carcinoid patient. Ann. Oncol 1997;8:1053–1054

    Article  Google Scholar 

  6. Frank M, Klose KJ, Wied M, et al. Combination therapy with octreotide and alpha-interferon: effect on tumor growth in metastatic endocrine gastroenteropancreatic tumors. Am. J. Gastroenterol. 1999;94:1381–1387

    PubMed  Google Scholar 

  7. Kolby L, Persson G, Franzen S, et al. Randomized clinical trial of the effect of interferon alpha on survival in patients with disseminated midgut carcinoid tumours. Br. J. Surg. 2003;90:687–693

    Article  PubMed  Google Scholar 

  8. Wallace S, Ajani JA, Charnsangavej C, et al. Carcinoid tumors: imaging procedures and interventional radiology. World J. Surg. 1996;20:147–156

    Article  PubMed  Google Scholar 

  9. Bessell JR, Karatassas A, Allen PW. Intestinal ischaemia associated with carcinoid tumour: a case report with review of the pathogenesis. J. Gastroenterol. Hepatol. 1994;9:304–307

    PubMed  Google Scholar 

  10. Eckhauser FE, Argenta LC, Strodel WE, et al. Mesenteric angiopathy, intestinal gangrene, and midgut carcinoids. Surgery 1981;90:720–728

    PubMed  Google Scholar 

  11. Harvey JN, Denyer ME, DaCosta P. Intestinal infarction caused by carcinoid associated elastic vascular sclerosis: early presentation of a small ileal carcinoid tumour. Gut 1989;30:691–694

    PubMed  Google Scholar 

  12. Payne James JJ, de Gara CJ, Lovell D, et al. Metastatic carcinoid tumour in association with small bowel ischaemia and infarction. J. R. Soc. Med. 1990;83:54

    Google Scholar 

  13. Qizilbash AH. Carcinoid tumors, vascular elastosis, and ischemic disease of the small intestine. Dis. Colon. Rectum 1977;20:554–560

    PubMed  Google Scholar 

  14. Strobbe L, D’Hondt E, Ramboer C, et al. Ileal carcinoid tumors and intestinal ischemia. Hepatogastroenterology 1994;41:499–502

    PubMed  Google Scholar 

  15. Sworn MJ, Reasbeck P, Buchanan R: Intestinal ischaemia associated with ileal carcinoid tumors. Br. J. Surg. 1978;65:313–315

    PubMed  Google Scholar 

  16. Warner TF, O’Reilly G, Lee GA. Mesenteric occlusive lesion and ileal carcinoids. Cancer 1979;44:758–762

    PubMed  Google Scholar 

  17. La Rosa S, Chiaravalli AM, Capella C, et al. Immunohistochemical localization of acidic fibroblast growth factor in normal human enterochromaffin cells and related gastrointestinal tumors. Virchows Arch. 1997;430:117–124

    Article  PubMed  Google Scholar 

  18. Modlin IM, Shapiro MD, Kidd M. Carcinoid tumors and fibrosis: an association with no explanation. Am. J. Gastroenterol. 2004;99:2466–2478

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Harry de Vries M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Vries, H., Wijffels, R.T.M., Willemse, P.H.B. et al. Abdominal Angina in Patients with a Midgut Carcinoid, a Sign of Severe Pathology. World J. Surg. 29, 1139–1142 (2005). https://doi.org/10.1007/s00268-005-7825-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7825-x

Keywords

Navigation