title: Colonic rupture in a patient on combination chemotherapy for metastasized carcinoma of the esophagogastric junction. Case report and review of the literature.
abstract: 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.
authors.affiliation: Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Policlinico G. B. Rossi, Verona, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Colucci
authors.forename: Walter
authors.initials: W
authors.lastname: Thaler
authors.forename: Hans
authors.initials: H
authors.lastname: Dejaco
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Marsoner
authors.forename: Alexia
authors.initials: A
authors.lastname: Grones
mesh_terms: 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
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil