ABSTRACT
A 70-year-old man presented with two medium-sized colon polyps at the office of a gastroenterologist. After endoscopic polypectomy in a hospital, the patient was admitted to another hospital because of collapse and increasing abdominal pain. CT scan revealed hematoperitoneum and splenic subcapsular hematoma. Laparotomy with splenectomy was performed because of extended splenic rupture. The postoperative course was unremarkable except late wound dehiscence.
Subject(s)
Colonic Polyps/complications , Colonic Polyps/surgery , Endoscopy/adverse effects , Spleen/injuries , Spleen/surgery , Wounds, Penetrating/etiology , Wounds, Penetrating/surgery , Aged , Humans , Male , Rupture/etiology , Rupture/surgery , Treatment OutcomeABSTRACT
Measurement of chromogranin A (CgA) level in blood can be used to monitor neuroendocrine tumours. However CgA level may also be elevated in several other endocrine and non-endocrine diseases. Here, we report on a patient with an incidental left-sided adrenal tumour and elevated CgA level. Adrenalectomy did not confirm clinically suspected diagnosis of pheochromocytoma. Postoperative follow-up was remarkable for a persistently elevated CgA level suspecting another neuroendocrine tumour which could not be detected despite extensive investigations. Finally, it was discovered that continuous proton-pump inhibitor administration for gastro-oesophageal reflux disease had caused a falsely elevated CgA level.
