title: Haemorrhage and perforation of gastrointestinal neoplasms during chemotherapy.
abstract: Gastrointestinal haemorrhage and perforation are known complications of cytotoxic therapy for chemosensitive tumours involving the wall of the gut, in particular non-Hodgkin's lymphoma. These complications can be avoided by aggressive surgery before chemotherapy is started. When they do occur, early operative intervention is essential to reduce morbidity and mortality. We report 4 cases in whom delay in diagnosis and surgery led to 3 deaths and suggest a policy for the management of such cases in the future.
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011239:Prednisolone / Q000009:adverse effects; D014750:Vincristine / Q000009:adverse effects
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone; D008727:Methotrexate