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Abdominal Crisis in the Malignant Carcinoid Syndrome

Arch Intern Med. 1966;117(2):256-260. doi:10.1001/archinte.1966.03870080100015.
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EPISODES of acute abdominal pain during the course of the malignant carcinoid syndrome often present a major challenge to physicians caring for patients with this unique disease. The primary tumor (usually in the small intestine) rarely causes symptoms until widespread metastases occur. Later in the course of the disease, patients are frequently plagued by episodes of acute abdominal pain.1-2 These may be secondary to intestinal obstruction and surgical intervention is often required.3-7 In contrast to causes of an "acute abdomen" which require surgical management, severe abdominal pain may also result from marked intestinal hyperperistalsis with or without diarrhea. Not infrequently the patient with carcinoid suffers acute abdominal pain when none of the above causes can be identified. Although sometimes referred to as "pseudocrises" the pain often is as severe as that of mechanical origin, patients are subjected to unnecessary surgery and management has been difficult. It is


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