A reversible enteropathy complicating continuous hepatic artery infusion chemotherapy with 5-fluoro-2-deoxyuridine.
This article describes two patients with hepatic metastases from colorectal cancer in whom a reversible enteropathy developed during the administration of hepatic artery infusion chemotherapy with 5-fluoro-2-deoxyuridine (5-FUdR) via an Infusaid Series 400 pump (Infusaid Corp., Sharon, MA). Both patients had severe diarrhea and signs that suggested small bowel obstruction. Barium studies revealed a distinctive radiologic appearance of severe narrowing of the ileum associated with complete loss of normal mucosal patterns. Results of an extensive evaluation for an infectious or toxin-related enterocolitis were negative. Perfusion studies confirmed the appropriate position of the catheters and revealed no extrahepatic perfusion. Systemic shunting of the 5-FUdR through the liver or tumor bed is postulated as the primary event, with the small bowel manifesting the major toxicity.
Gluck
W L
WL
Akwari
O E
OE
Kelvin
F M
FM
Goodwin
B J
BJ
D000368:Aged; D005467:Floxuridine / Q000008:administration & dosage / Q000009:adverse effects*; D006499:Hepatic Artery; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000187:drug effects; D007261:Infusions, Intra-Arterial / Q000295:instrumentation; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000187:drug effects; D007813:Laparotomy; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011859:Radiography
D005467:Floxuridine