Paraneoplastic chronic intestinal pseudoobstruction as a rare complication of bronchial carcinoid. Issue 7 (July 1992)

• Record Type: Journal Article
• Authors: Gerl, A; Storck, M; Schalhorn, A; Müller-Höcker, J; Jauch, K W; Schildberg, F W; Wilmanns, W
• Is Part Of: Gut. Volume 33:Issue 7(1992)
• Page Start: 1000
• Page End: 1003
• Publication Date: 1992-07
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.33.7.1000
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : This report describes paraneoplastic visceral neuropathy including achalasia, gastroparesis, subileus and constipation in a 59 year old patient with metastasising atypical bronchial carcinoid. Achalasia was successfully treated by cardiomyotomy and fundoplication; additionally, extramucosal pylorectomy was undertaken to improve gastric emptying. Endoscopic papillotomy was necessary because of a functional stenosis of the sphincter of Oddi with development of obstructive jaundice. Symptoms of intestinal pseudoobstruction did not improve with cisapride or corticosteroid treatment. Histological examination of gastrointestinal specimens revealed a lymphocytic infiltration of the myenteric plexus associated with loss of neurones. The rheumatoid factor was positive, there was evidence of circulating immune complexes and antibodies to Sm-antigen were present, suggesting a possible autoimmune pathogenesis.