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Carcinoid tumour with rare clinical presentation: a case report

Carcinoid with rare presentation, and a literature review. A 58-year-old woman died in our intensive care unit (ICU) where she had been admitted for urgent ventriculotomy for a bleeding gastric ulcer. Chest radiography showed bilateral pulmonary infiltration, and respiratory support was introduced. Peristalsis was silent. Coma, tachycardia and high temperature were present, which did not respond to therapy. Hyperthyreosis therapy was started empirically. Melaena, as a sign of gastrointestinal bleeding, was observed. Control chest radiography showed infiltrate regression and normalised temperature, but despite these features the patient died. Clinical diagnosis included status, post-operation, of gastric ulcer, haemorrhagic shock, pneumonia, sepsis. Autopsy revealed massive intestinal bleeding due to primary exulcerated small intestine carcinoid. Primary condition was aggravated by bilateral consolidated suppurative bronchopneumonia, sepsis and nodular goitre. Since the patient was operated on in emergency, insufficient analyses were made. Melaena 5 days after the operation misled clinicians and pointed towards possible suture rupture due to sepsis. Tachycardia and hypertonia were recognised as untreated hyperthyreosis symptoms. Intestinal carcinoid was not suspected.

Autopsy; Intensive care unit; Intestinal carcinoid

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