Hashimoto Y, Motoyoshi S, Maruyama H, Sakakida M, Yano T, Yamaguchi K, Goto K, Sugihara S, Takano S, Kambara T
Department of Metabolic Medicine, Kumamoto University Medical School, Japan.
Jpn J Med. 1990 May-Jun;29(3):341-6. doi: 10.2169/internalmedicine1962.29.341.
The case of a 59-year-old man with paralytic ileus (pseudo-obstruction) associated with pheochromocytoma is reviewed. Paralytic ileus is believed to have been the result of overstimulation of alpha and beta receptors on the intestine by catecholamines. Phentolamine, bunazocin, propranolol, bethanechol and midaglizole in single administrations or in combination were administered. Phentolamine infusion clearly relieved the symptom, but ileus recurred, and the patient died of respiratory failure, liver dysfunction and disseminated intravascular coagulation syndrome. The significant role of catecholamines in causing these symptoms is discussed, and the management of this relatively rare complication is reviewed.
