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[Manifestations of local fibrosis in the clinical picture of carcinoids of digestive organs].

A complex of clinical, functional, and morphological studies was made in 20 patients aged 39 to 78 years who had histologically verified gastrointestinal carcinoids in the pre- and postoperative periods, by employing laboratory tests and instrumental techniques. Removed tumors were morphologically studied. Sixteen patients were operated on. Among them, 10 and 6 patients underwent planned and emergency operations, respectively. On referral for emergency laparotomy, the preoperative diagnoses were acute ileus in 2 cases, acute pancreatitis in 1, and acute appendicitis in 3. The local paracrine effect of serotonin on the intestinal wall leads to spasm and fibrosis, which manifests itself as the clinical picture of obstruction of a hollow organ or acute appendicitis. Cordlike or concentrated deformity as a kink is a characteristic sign of small intestinal carcinoid. Formation of fibrosis occurs not only in the pathways of evacuation of excess serotonin from hepatic metastases into the right ventricle of the heart (Hedinger's syndrome), but by the paracrine pathway in the immediate vicinity of a carcinoid tumor, in whatever organ the tumor is located.