Intestinal Bleeding and Perforation Complicating Treatment with Vasoconstrictors

Brown, Robert B.; Rice, Bruce H.; Szakacs, Jeno E.

doi:10.1097/00000658-195911000-00002

Cited by 45 publications

(8 citation statements)

References 12 publications

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“…Szakacs, 7 who in a well controlled experiment using dogs, found evidence of a necrotizing arteritis in the GI tract and splenic infarcts in addition to cardiac lesions, employed doses as high as 15 ju,g/kg/min for 10 hours, and doses up to 2.8 /i.g/kg/min for as long as 327 hours. Brown et al, 10 in three dogs, gave 0.8 to 2.8 /i.g/kg/min for four to sixteen days and also noted infarction and perforation of the ileum and a proliferative necrotizing endarteritis.…”

Section: Discussionmentioning

confidence: 95%

“…19 In the clinical studies of Boughton et al,-Brown et al, 10 and Chung et al, 11 NE was administered to patients for the purpose of treating shock. Under these conditions it becomes extremely difficult, if not impossible, to differentiate on morphologic grounds the etiologic factors responsible for the development of the lesions described.…”

Section: Discussionmentioning

confidence: 99%

“…Nahas et al, 9 in 1958, found that infusions of NE in heart lung preparations of dogs resulted in extensive degenerative and hemorrhagic lesions in the myocardium, cardiac valves and coronary vessels, and that these lesions were aggravated by the concomitant infusion of hydrocortisone. Brown, et al, 10 an indwelling catheter in the central artery of the left ear, and recorded with a Statham 23AA pressure transducer and a Grass polygraph recorder. Groups of animals were autopsied at intervals from 15 minutes to 2 weeks after the infusion period.…”

Section: These Authors Described Similarmentioning

confidence: 99%

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Cardiovascular Effects of Sustained Norepinephrine Infusions. II. Morphology

Schenk

Moss

1966

Circulation Research

102

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Methods1. Seventy-five rabbits weighing 2.5 to 3.5 kg were studied, without general anesthesia but with 0.5 ml of lidocaine (Xylocaine) infiltrated at the base of the left ear for local anesthesia. Norepinephrine diluted in 15 ml of 5% dextrose and water was infused into the left marginal ear vein through an indwelling catheter. Three groups of rabbits received 0.1 to 0.4, 0.8 to 1.2, and 1.5 to 3 /Ag/kg/min of NE base for periods of 1 to 15 hours. Control animals were infused with 5% dextrose and water. Arterial blood pressure was measured in 24 animals by means of *Myofiber is used to mean cardiac muscle cell.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: These Authors Described Similarmentioning

confidence: 99%

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Cardiovascular Effects of Sustained Norepinephrine Infusions. II. Morphology

Schenk

Moss

1966

Circulation Research

102

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“…These observations suggest an involvement of catecholamines reieased from the adrenal medulla in the production of gastric ulcers by adrenaline. Furthermore, parenteral catecholamines have been shown to produce gastric ulceration (Brown, Rice & Szakacs, 1959;Sethbhakdi, Pfeiffer & Roth, 1970). Acetylcholine (i.c.v.…”

Section: Discussionmentioning

confidence: 99%

Study of Central Neurotransmitters in Stress‐induced Gastric Ulceration in Albino Rats

Bhargava

Daas

Gupta

et al. 1980

British J Pharmacology

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l Restraint when combined with cold (4°C) consistently induces gastric ulceration in rats at 2 h. The cold-restraint ulcer (CRU) technique provides a suitable model for acute studies. 2 The peripheral mechanisms in CRU seem to be increased sympathetic and parasympathetic outflow since CRU was significantly reduced by prior spinal transection or vagotomy or by appropriate blocking agents. Since metiamide significantly reduced CRU, H2-histamine receptors are also involved. 3 Central catecholaminergic as well as cholinergic mechanisms seem to be responsible for the activation of peripheral sympathetic and parasympathetic outflow in CRU, since central administration of dibenamine, propranolol, 6-hydroxydopamine and atropine prevented the CRU. 4 Exogenous administration of putative neurotransmitters (adrenaline, noradrenaline and acetylcholine) into the cerebroventricular system produced gastric ulceration similar to CRU. However, dopamine, histamine and 5-hydroxytryptamine failed to induce gastric ulceration. 5 The results with intracerebroventricular adrenaline and acetylcholine indicate a central cholinergic link distal to adrenergic activation in the ulcerogenesis. 6 Intracerebroventricular adrenaline-induced gastric ulceration appears to be most akin to CRU.

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“…We think that our patient had transient episodes of intestinal ischaemia that were severe enough to impair its absorptive, secretory and immunologic functions,10 but not to produce intestinal necrosis. This phenomenon may resemble the pathophysiology of what is observed after abdominal aortic operations, where transient episodes of intestinal ischaemia may occur and cause bacteraemia from intestinal organisms leading to multiple organ failure syndrome 7 , 11…”

Section: Discussionmentioning

confidence: 84%

Multiple organ failure secondary to multiple organism bacteraemia associated with intestinal ischaemia in a patient with a phaeochromocytoma

Díaz¹,

Astudillo

2009

Case Reports

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Phaeochromocytomas are rare catecholamine secreting tumours that usually present as paroxysms of hypertension associated with headache, palpitations and sweating. We report the case of a 50-year-old man with a phaeochromocytoma who presented with sudden onset of hypertension, syncope, and fever who later developed a multiple-organ failure secondary to a multiple organism bacteraemias due to transient episodes of intestinal ischaemia. After receiving full intensive care support, antibiotics and tumour removal, the patient made a complete recovery and he is at present doing well. This case illustrates that high concentrations of catecholamine secreted by a phaeochromocytoma might cause multiple organ failure syndrome secondary to multiple organism bacteraemias due to transient episodes of intestinal ischaemia.

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Intestinal Bleeding and Perforation Complicating Treatment with Vasoconstrictors

Cited by 45 publications

References 12 publications

Cardiovascular Effects of Sustained Norepinephrine Infusions. II. Morphology

Cardiovascular Effects of Sustained Norepinephrine Infusions. II. Morphology

Study of Central Neurotransmitters in Stress‐induced Gastric Ulceration in Albino Rats

Multiple organ failure secondary to multiple organism bacteraemia associated with intestinal ischaemia in a patient with a phaeochromocytoma

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