Carcinoid syndrome see also Section

1, Carcinoid syndrome)

Less than 25% of patients with carcinoid tumours have carcinoid syndrome.The majority with the syndrome have liver metastases. Exceptions are the tumours whose venous drainage bypasses the liver. Flushing and hypertension have occurred rarely during anaesthesia in the absence of metastases (Jones & Knight 1982), and these were attributed to release of hormones resulting from manipulation of the tumour itself. Preoperative features include flushing, diarrhoea, wheezing and valvular lesions of the heart.The patient may present unexpectedly, during anaesthesia or ar investigative procedures, with cardiovascular or §■

respiratory complications from secretion of £

vasoactive chemical mediators such as serotonin, n bradykinins, tachykinins, prostaglandins, or |

histamine. Octreotide, a somatostatin analogue, e is now the most important antagonist for prophylaxis, or the treatment of complications of carcinoid syndrome. A new longer-acting somatostatin analogue, lanreotide, has recently been introduced (Ruszniewski et al 1996).

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