Fisch H P, Reutter F W
Schweiz Med Wochenschr. 1976 Aug 28;106(35):1187-91.
Following adrenal phlebography, obstruction of the large bowel associated with adrenergic crisis was observed in a 60 year old patient with pheochromocytoma. As in other published cases of ileus associated with pheochromocytoma, high urinary catecholamine concentrations were found in our patient and the tumor resected at surgery was large. As phlebography immediately preceded the onset of ileus and hypertensive crisis, it is postulated that angiography led to massive secretion of catecholamines, which caused the hypertensive crisis as well as the ileus. The possible mechanisms by which phlebography may lead to adrenergic crisis are discussed. It is concluded that in suspected pheochromocytoma all angiographic examinations should be carried out under simultaneous treatment with alpha-blocking agents.
在肾上腺静脉造影后，一名60岁嗜铬细胞瘤患者出现了与肾上腺素能危象相关的大肠梗阻。正如其他已发表的与嗜铬细胞瘤相关的肠梗阻病例一样，我们的患者尿儿茶酚胺浓度很高，手术切除的肿瘤很大。由于静脉造影紧接着肠梗阻和高血压危象发作之前进行，推测血管造影导致了儿茶酚胺的大量分泌，进而引发了高血压危象和肠梗阻。文中讨论了静脉造影可能导致肾上腺素能危象的潜在机制。得出的结论是，对于疑似嗜铬细胞瘤患者，所有血管造影检查均应在同时使用α受体阻滞剂治疗的情况下进行。
