Colonic rupture in a patient on combination chemotherapy for metastasized carcinoma of the esophagogastric junction. Case report and review of the literature.
BACKGROUND
Cecal perforation due to neutropenic colitis is a known and described side effect of many chemotherapy regimens. We present a case of a patient with gastric adenocarcinoma who developed spontaneous cecal perforation during chemotherapy without the classic pattern of typhlitis.


METHODS
A 58-year-old woman was on chemotherapy for an adenocarcinoma of the gastric junction, when she developed a cecal perforation. There was neither evidence for leucopenia nor for typhlitis. Laparotomy was performed and cecostomy was established using the perforated bowel. Postoperative course was uneventful. The patient died from tumor progression 8 months after the diagnosis was made.


CONCLUSIONS
There is no evidence for a connection between this event and chemotherapy treatment but neither can it be excluded. Even if unusual, colon toxicity could be a potential life-threatening complication associated with more drugs than usually thought.
Colucci
Gianluca
G
Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Policlinico G. B. Rossi, Verona, Italy.
Thaler
Walter
W
Dejaco
Hans
H
Marsoner
Hansjörg
H
Grones
Alexia
A
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D002429:Cecal Diseases / Q000139:chemically induced*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003108:Colonic Diseases / Q000139:chemically induced; D000077143:Docetaxel; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D008875:Middle Aged; D012421:Rupture / Q000139:chemically induced; D013274:Stomach Neoplasms / Q000188:drug therapy*; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil