Okumura Saki, Sumie Makoto, Karashima Yuji
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan.
Operating Rooms, Kyushu University Hospital, Fukuoka, Japan.
JA Clin Rep. 2019 May 23;5(1):35. doi: 10.1186/s40981-019-0255-9.
Intestinal pseudo-obstruction, which is a rare complication of pheochromocytoma, can be caused by hypersecreted catecholamines.
A 45-year-old woman was admitted for local recurrence of pheochromocytoma complicated by intestinal pseudo-obstruction. The intestinal pseudo-obstruction showed poor response to α-adrenergic receptor blocker and she was scheduled for surgical resection of pheochromocytoma. The surgery was uneventfully accomplished with general anesthesia combined with epidural anesthesia. The latter was performed with the aim of not only perioperative pain management but also of promoting intestinal peristalsis. The anticipated effect for intestinal peristalsis was not apparent in the early postoperative phase. The abdominal symptoms were gradually relieved over the course of about 1 month.
For intestinal pseudo-obstruction induced by pheochromocytoma, although inhibition of the sympathetic system by epidural infusion of local anesthetics may be promising, short-term usage of epidural local anesthetics infusion did not provide a quick recovery after pheochromocytoma removal surgery.
肠道假性梗阻是嗜铬细胞瘤的一种罕见并发症，可由儿茶酚胺分泌过多引起。
一名45岁女性因嗜铬细胞瘤局部复发并伴有肠道假性梗阻入院。肠道假性梗阻对α-肾上腺素能受体阻滞剂反应不佳，她计划接受嗜铬细胞瘤手术切除。手术在全身麻醉联合硬膜外麻醉下顺利完成。进行硬膜外麻醉不仅是为了围手术期疼痛管理，也是为了促进肠道蠕动。术后早期肠道蠕动的预期效果并不明显。腹部症状在大约1个月的时间里逐渐缓解。
对于嗜铬细胞瘤引起的肠道假性梗阻，尽管硬膜外输注局部麻醉药抑制交感神经系统可能是有前景的，但硬膜外局部麻醉药短期输注在嗜铬细胞瘤切除术后并不能带来快速恢复。
