Acute abdominal symptoms in malignant hypertension: Clinical presentation in five cases

Malignant hypertension causes anatomical and functional damage in several t arget organs, in particular brain, retina, heart and kidneys. Although vasc ular lesions in the gastroenteric tract are known to occur in several insta nces, their clinical relevance is unknown. In this study five cases of malignant hypertension, presenting with acute a bdominal symptoms, are reported. A history of essential arterial hypertensi on was present in three patients; while one patient had a previous diagnosi s of renovascular hypertension and one patient had renoparenchymal hyperten sion. However, in all cases the antihypertensive treatment was discontinued and inadequate before the accelerated malignant phase. The acute abdominal symptoms at presentation were due to intestinal infarction in 3 patients a nd acute pancreatitis in 2 patients. One patient with intestinal infarction died of postoperative cardiogenic shock. Our data are in agreement with pr evious reports describing the possible intra-abdominal complications of mal ignant hypertension. The therapeutic approach in such conditions should alw ays consider an effective antihypertensive treatment in conjunction with su rgical options.