[Chemotherapy-induced thrombotic occlusion of mesenteric arteries--case report and review of the literature].
We encountered two chemotherapy (CDDP and 5-FU) cases related to mesenteric thrombotic occlusion. Case 1 was a 26 yo male with adrenal carcinoma recurrence. He had been treated by CDDP and 5-FU. Five days after completion of the second course, he suffered from acute abdomen. Laparotomy revealed thrombotic occlusion of the superior mesenteric artery. Most of the small intestine and a part of the ascending colon were necrotic. Case 2 was a 60 yo female with lung and hepatic metastasis from uretal tumor. CDDP based chemotherapy was initiated. Severe abdominal pain and melena occurred one day after completion of the second course of chemotherapy. The inferior mesenteric artery was occluded and the descending colon was necrotic. Recently, a variety of chemotherapy-induced vascular lesions, including thrombotic microangiopathy, myocardial infarction and cerebral infarction, have been reported. CDDP and 5-FU were shown to be related to the acute thrombotic occlusion of the major vessels. Although the incidence is rare, the prognosis is poor. Acute vascular obstruction should be taken into consideration as a possible course of chemotherapy-related complications.
Okamoto
T
T
First Dept. of Surgery, Yokohama City University School of Medicine.
Noguchi
Y
Y
Yoshikawa
T
T
Nomura
K
K
Fukuzawa
K
K
Uranaka
Y
Y
Makino
T
T
Tsuburaya
A
A
Amano
T
T
Matsumoto
A
A
D000006:Abdomen, Acute / Q000139:chemically induced; D000310:Adrenal Gland Neoplasms / Q000188:drug therapy; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000139:chemically induced*; D008875:Middle Aged; D013927:Thrombosis / Q000139:chemically induced; D014516:Ureteral Neoplasms / Q000188:drug therapy
D002945:Cisplatin; D005472:Fluorouracil