Intestinal Perforation in ACTH-Dependent Cushing’s Syndrome

Table 2

Previous and current cases of patients with Cushing’s syndrome and intestinal perforation.

Reference	Age	Gender	Highest UFC (nmol/24 h) / Plasma cortisol (PC, nmol/L)	Cause of Cushing’s syndrome	Hypokalemia	Time from onset of CS (months)	Required Sx and/or surgical finding
Drake et al. [11]	35	Male	PC = 1442	Islet cell tumor	Yes	1	Duodenal perforation and rupture of pancreatic pseudocyst
Lutgers et al. [12]	55	Female	10152	Right pheochromocytoma	Yes	1	Perforated sigmoid diverticulum
De Havenon et al. [13]	71	Female	PC = 2593 after 8 mg dexamethasone	Cushing’s disease	Yes	9	Diverticular rupture
Hara et al. [14]	79	Male	PC = 1230	Cushing’s disease	Yes	6	Perforation of colonic diverticulum
Kaya et al. [15]	70	Male	PC = 1432	Small cell lung carcinoma	Yes	1	Diverticular rupture in the rectosigmoid area
Matheny et al. [16]	67	Male	11119	Metastatic medullary carcinoma of thyroid	Yes	4	Drainage and IV antibiotics for perforated diverticulum
Dacruz et al. [17]	60	Female	4481	Metastatic parotid tumor	Yes	5	Perforated sigmoid diverticulitis
Flynn et al. [18]	63	Female	12465	Pheochromocytoma	Yes	1	Hemicolectomy for perforation at the splenic flexure
Sater et al. [19]	80	Female	5601	Lung carcinoid	Yes	36	Acute diverticulitis perforation and serositis
Sater et al. [19]	60	Female	72726	Metastatic islet cell carcinoma	Yes	36	Sigmoid resection with colostomy
Sater et al. [19]	31	Male	1297	Cushing’s disease	No	20	Acute and chronic inflammation of left colon and retroperitoneal tissue with focal abscess
Sater et al. [19]	52	Female	2371	Lung carcinoid	Yes	4	Acute diverticulitis with rupture and abscess formation
Sater et al. [19]	67	Male	3836	Ectopic ACTH (not localized)	No	10	Acute sigmoid diverticular rupture rupture complicated by a peri-colic abscess
Sater et al. [19]	51	Male	13552	Metastatic thymic carcinoma	Yes	4	Partial colon resection with colostomy
Current	72	Female	5296	Pancreatic neuroendocrine tumor	Yes	12	Hartmann procedure for diverticular rupture
Current	61	Female	PC = 1925	Metastatic medullary carcinoma of thyroid	Yes	12	Palliative
Current	68	Female	410	Cushing’s disease	No	12	IV antibiotics (first episode); Right hemicolectomy (second episode)
Current	71	Female	1533	Cushing’s disease	Yes	4	IV antibiotics
Current	54	Male	374	Cushing’s disease	No	3	Sigmoid colon perforation
Current	52	Female	885	Cushing’s disease	Yes	16	Colectomy for diverticular rupture

An estimate only as some patients had intestinal rupture after definitive treatment of their Cushing’s syndrome (CS).