[Acute abdomen in unrecognized hyperparathyroidism]

Abstract

The incidence of acute abdomen in patients with unrecognised hyperparathyroidism (HPT) was investigated in 61 patients with primary and 15 patients with secondary HPT, operated on at the Surgical University Department in Düsseldorf between 4/86 and 10/87. In seven patients (9%) an acute abdomen occurred preoperatively (bleeding ulcer n = 3, ulcer perforation n = 1, acute pancreatitis n = 3). Recurrent gastrointestinal disease was observed in 20 of the 76 Patients (28%). The fast and surprising clinical recovery of patients with pancreatitis and HPT after operation of the HPT support the assumption of a causal relation between hyperparathyroidism and pancreatitis. The importance of hypercalcaemia and HPT as causative factors in gastrointestinal ulcers, remains uncertain, however. Possible acute abdominal emergencies in the clinical course of primary hyperparathyroidism support the indication for early operation.