Acute pseudo-obstruction of the small intestine following high-dose chemotherapy and stem cell support.
BACKGROUND
Acute intestinal pseudo-obstruction is a potentially life-threatening disease which is characterized by massive dilation of the colon or small intestine without mechanical obstruction and may develop after surgery or severe illness.


METHODS
We report 2 cases in which acute small intestinal pseudo-obstruction occurred after high-dose chemotherapy and autologous stem cell support. In 1 patient explorative abdominal laparoscopy was performed to rule out mechanical ileus. However, after having initiated treatment with acetylcholinesterase inhibitors a prompt small intestinal decompression was observed in both patients.


CONCLUSIONS
Acetylcholinesterase inhibitors should be considered as an early conservative intervention in the treatment of acute intestinal pseudo-obstruction to avoid surgery of patients undergoing high-dose chemotherapy with autologous stem cell support.
Bauernhofer
T
T
Klinische Abteilung für Onkologie, Medizinische Universitätsklinik, Karl-Franzens-Universität Graz, Austria. thomas.bauernhofer@kfunigraz.ac.at
Eibl
M
M
Ploner
F
F
Kuss
I
I
Pfeifer
J
J
Sill
H
H
Samonigg
H
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D044584:Carcinoma, Ductal / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000139:chemically induced* / Q000628:therapy; D007421:Intestine, Small; D008297:Male; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy*; D013736:Testicular Neoplasms / Q000188:drug therapy*