Well I am sure that all of you are familiar with carcinoid tumors and carcinoid crisis, if not this thread will explain it nicley, just ignore the snarky MD stuf. On this post they really were not to bad. http://forums.studentdoctor.net/show...arcinoid+tumor

I had a case and had a carcinoid crisis, I think but it was a strange one.

Pt 71 Y/O W/F with niddm and HTN and CANCER!!!!

Open small bowel resection. Lady not to bad just finished a round of chmemo and a round of encapsulated liver chemo for liver mets.

20 min. into case pressure starts to drop, not a big deal I expect it to as I have increased my volitile agent for a pressure 0f 160/85. Pressure goes down to 106/50 and then O2 sat starts to drop down to 89% and staying there refractoey to bagging or increased flows or decreased agent, heard some faint wheezes so checj and give albeuterol, nada, OK maybe my ETT migrated Nope clear bilateral breath sounds. PE? O change in heart rate or CO2 and other then the gradual drop in BP that I EXPECTED.

WEll after 10 min of hand wringing the sat starts to go back up, after thinking about it I realizr that the carcinoid tumor must be doing its thing and the reason I am not seeing a full blown crisis is that her liver is working just not as well as it should.
I had gotten 100 mcgs of sandostatin before the case in case of a crisis, it happened but I did not recognize it, I expected somthing far greater, if her liver had not been working it would have been, cheap lesson.