Pneumatosis cystoides intestinalis after fluorouracil chemotherapy for rectal cancer.
Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, although fluorouracil-related PCI is extremely rare. We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV). After 1 cycle of the treatment, he presented with diarrhea and abdominal pain. Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine. Laparotomy was performed, showing a suspected diagnosis of perforation in the gastrointestinal tract. Intraoperative findings revealed penumatosis of the intestine without evidence of perforation. He was treated supportively and his symptoms improved. In conclusion, we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.
Mimatsu
Kenji
K
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho Naka-ku Yokohama, Kanagawa 231-8553, Japan. mimatsu.kenji@yokochu.jp
Oida
Takatsugu
T
Kawasaki
Atsushi
A
Kano
Hisao
H
Kuboi
Youichi
Y
Aramaki
Osamu
O
Amano
Sadao
S
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003113:Colonoscopy; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D005774:Gastrostomy; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D010288:Parenteral Nutrition; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002955:Leucovorin; D010100:Oxygen; D005472:Fluorouracil