Carcinoid and hypocoagulation state in geriatric patients: a rare case

Materials and methods We observed a 79-year-old patient suffering from high blood pressure and Alzheimer, with an history of periodic abdominal pain from almost 2 months and 10 Kg weight loss in the last month. In suspicious of a carcinoid, the patient underwent scintigraphy with In-111 showing the presence of two abnormal focal buildup of the trace compatible with the presence of a productive tissue with somatostatin receptors. Lab exams were normal, except for the serum Chromogranin A (42.0 U/l), the 5 OH indole acetic acid (11.0 mg/24 h) and the urinary VanillylMandelic acid (7.0 mg/24 h). Therefore the patient underwent surgery. The patient had a regular course until the third post-operative day when an acute anemia appeared (GR 2460000, Hb 7.0 g/dl, HCT 22.3%). Therefore we performed an emergency intervention that showed the presence of diffuse bleeding from the parietal and visceral peritoneum with haemorragic filling of the transverse mesocolon. Results The association between carcinoid and hypocoagulative state is rare and their connection is not yet clear.