title: [A Case of Fournier's Gangrene Caused by Small Intestinal Perforation during Bevacizumab Combination Chemotherapy].
abstract: A 51-year-old man underwent abdominoperineal resection for advanced rectal cancer at a hospital. He attended our outpatient clinic 58 months later with pain in the external genitalia, and was diagnosed with local pelvic recurrence and metastasis to the para-aortic lymph node and both adrenal glands. He received a total of 30 Gy of radiation for analgesia; subsequently, chemotherapy(mFOLFOX6 plus bevacizumab)was initiated. However, extreme left buttock and left femoral pain developed after the 6 courses of chemotherapy. Abdominal CT revealed Fournier's gangrene caused by small intestinal perforation. Emergency drainage under spinal anesthesia was immediately performed. Two additional drainage procedures were required thereafter and an ileostomy was constructed. The patient was discharged 100 days after the initial drainage. This is an extremely rare example of a bevacizumab-related small intestinal perforation that developed into Fournier's gan- grene.
authors.affiliation: Dept. of Surgery, Saiseikai Utsunomiya Hospital.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Shinozaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ozawa
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Subaru
authors.initials: S
authors.lastname: Kato
authors.forename: Taiga
authors.initials: T
authors.lastname: Wakabayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Yuuichi
authors.initials: Y
authors.lastname: Sasakura
authors.forename: Tetsuichiro
authors.initials: T
authors.lastname: Shimizu
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Terauchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Kimata
authors.forename: Junji
authors.initials: J
authors.lastname: Furukawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Ogata
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000009:adverse effects*; D059248:Chemoradiotherapy; D004322:Drainage; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage; D018934:Fournier Gangrene / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil