Nonocclusive Mesenteric Ischemia Associated with Propranolol Overdose

Abstract

SummaryWe describe a case of massive propranolol overdose in a healthy 19‐year‐old woman associated with isolated mesenteric ischemia following shock. We postulate that endogenous catecholamine release from shock combined with massive β‐adrenergic blockade led to severe splanchnic vasoconstriction from unopposed α‐adrenergic activity. This case supports current thinking regarding the effect of vasoactive mediators on the gastrointestinal tract in humans and might be relevant to the mechanism of action of propranolol in the prophylaxis of variceal bleeding.