title: Ileal perforation caused by cytomegalovirus infection in a patient with recurrent gastric cancer: report of a case.
abstract: We report a case of ileal perforation caused by cytomegalovirus (CMV) infection in a patient with peritoneal recurrence of gastric cancer. Emergency laparotomy revealed a pinhole-sized perforation in a reddish segment of the small bowel, 100 cm proximal to the terminal ileum, and peritoneal carcinosis of recurrent gastric cancer invading the transverse colon and the gastrojejunal anastomosis of a Billroth-II procedure. The affected ileum was resected, a primary anastomosis was performed, and a colostomy was made in the ascending colon. The histology of the ileum revealed acute inflammation with vasculitis and CMV inclusions in the macrophages and endothelial cells and evidence of CMV on immunostaining. There was no evidence of cancer cell invasion or any other pathogens. Although the prognosis associated with bowel perforation due to CMV infection is poor, emergency surgery saved our patient's life.
authors.affiliation: Second Department of Surgery, Gunma University School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kawate
authors.forename: Susumu
authors.initials: S
authors.lastname: Ohwada
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sano
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kishikawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Tomizawa
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
authors.forename: Fumio
authors.initials: F
authors.lastname: Watanuki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishita
mesh_terms: D003586:Cytomegalovirus Infections / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D007416:Intestinal Perforation / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D013274:Stomach Neoplasms / Q000150:complications*