title: Colonic stenosis caused by infection of an intraperitoneal access port system: a rare complication of intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis.
abstract: BACKGROUND
  Intraperitoneal (i.p.) chemotherapy is garnering attention as an effective treatment for gastric cancer with peritoneal metastasis. We report the case of a patient who developed colonic stenosis caused by infection of an i.p. access port system during i.p. chemotherapy. It was difficult to differentiate whether the extrinsic colonic stenosis arose from a catheter infection or peritoneal metastasis of the gastric cancer.
  
  
  METHODS
  A 66-year-old Japanese man underwent total gastrectomy for gastric cancer. Because the intraoperative findings revealed peritoneal metastasis, a port system was implanted for subsequent i.p. chemotherapy. Two months after initiation of chemotherapy, he complained of vomiting and abdominal pain. A computed tomography scan revealed marked thickening of the sigmoid colon wall adjacent to the catheter of the i.p. access port system. A barium enema demonstrated extrinsic irregular stenosis of the sigmoid colon. Although it was difficult to distinguish whether infection or peritoneal metastasis had caused the colonic stenosis, we removed the port system to obtain a therapeutic diagnosis. Coagulase-negative staphylococci were detected by catheter culture. The wall thickening and stenosis of the sigmoid colon completely resolved after removal of the port system.
  
  
  CONCLUSIONS
  We report the case of a rare complication in association with an i.p. access port system. Infection of the port system should be considered as a differential diagnosis when colonic stenosis adjacent to the catheter is observed during i.p. chemotherapy.
authors.affiliation: Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan. junkino0416@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Kinoshita
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Tomoya
authors.initials: T
authors.lastname: Tsukada
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Oyama
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Keishi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Miyashita
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D055499:Catheter-Related Infections / Q000150:complications*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology*; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology*; D005743:Gastrectomy; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D010529:Peritoneal Cavity; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000556:secondary; D011379:Prognosis; D013274:Stomach Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D062666:Vascular Access Devices / Q000009:adverse effects*