title: A refractory duodenal ulcer with a biliary-duodenal fistula following the administration of bevacizumab.
abstract: A 65-year-old woman with recurrent breast cancer was repeatedly treated with bevacizumab, an anti-VEGF antibody. In addition, she was also frequently prescribed a nonsteroidal anti-inflammatory drug for abdominal pain. Melena was revealed 2 months after the final treatment with bevacizumab, and an endoscopic study revealed a duodenal ulcer (DU) that was resistant to anti-ulcer therapy. A cholangiography identified a biliary-duodenal fistula with bile juice leaking from the ulcer base. Therefore, a biliary stent was placed into the common bile duct for 3 months until the DU healed. This is the first case of a refractory DU with a biliary-duodenal fistula in a patient treated with bevacizumab.
authors.affiliation: Department of Gastroenterology, Gihoku Kosei Hospital.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Horibe
authors.forename: Seiji
authors.initials: S
authors.lastname: Adachi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Okuno
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ohno
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.forename: Midori
authors.initials: M
authors.lastname: Iwama
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamauchi
authors.forename: Koshiro
authors.initials: K
authors.lastname: Saito
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Masahito
authors.initials: M
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000068258:Bevacizumab / Q000009:adverse effects* / Q000627:therapeutic use; D001658:Biliary Fistula / Q000150:complications*; D001943:Breast Neoplasms / Q000188:drug therapy; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000628:therapy; D005260:Female; D006801:Humans; D012008:Recurrence; D015607:Stents
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab