Intraoperative Small Bowel Obstruction (SBO) Concerning for Carcinoid Syndrome

Abstract

Carcinoid crisis is a rare, life-threatening complication of neuroendocrine tumors triggered by surgical manipulation or anesthesia. We present a 57-year-old male with small bowel obstruction due to a suspected carcinoid tumor who developed profound hypotension and bradycardia intraoperatively. Hemodynamic instability was managed with vasoactive agents and octreotide bolus followed by continuous infusion, resulting in stabilization and successful extubation. Surgical exploration revealed liver metastases, a major risk factor for carcinoid crisis. This case highlights the importance of preparedness, rapid intervention, and anesthesiologist vigilance in managing intraoperative carcinoid crises.