title: Pneumatosis intestinalis after gefitinib therapy for pulmonary adenocarcinoma: a case report.
abstract: BACKGROUND
  Pneumatosis intestinalis (PI) is defined as the presence of gas in the bowel wall and is a relatively rare finding. PI has been associated with various pathological conditions and medications. Although several chemotherapeutic agents and molecular targeted therapy agents are reported to be associated with PI, there have been few reports describing the association between the anti-epidermal growth factor receptor agent gefitinib, a tyrosine kinase inhibitor (TKI), and PI. The present report describes a case of PI secondary to gefitinib therapy.
  
  
  METHODS
  An 80-year-old woman who had been diagnosed with recurrent lung adenocarcinoma presented with remarkable appetite loss, abdominal distension, and constipation after starting gefitinib therapy. A computed tomography (CT) scan of the abdomen revealed PI extending from the small intestine to the rectum. The patient was managed conservatively, and gefitinib therapy was discontinued. Subsequently, the symptoms improved and a follow-up abdominal X-ray showed a reduction in intramural air. After gefitinib was restarted, PI occurred three more times.
  
  
  CONCLUSIONS
  Although PI is extremely rare, physicians should be aware of the risk of PI in patients undergoing gefitinib therapy.
authors: Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. amaeda@med.kawasaki-m.ac.jp.
authors: Ai
authors: A
authors: Maeda
authors: Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors: Masao
authors: M
authors: Nakata
authors: Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors: Katsuhiko
authors: K
authors: Shimizu
authors: Department of General Surgery, Kawasaki Medical School, Okayama, Okayama, 700-8505, Japan.
authors: Takuro
authors: T
authors: Yukawa
authors: Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors: Shinsuke
authors: S
authors: Saisho
authors: Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors: Riki
authors: R
authors: Okita
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000077192:Adenocarcinoma of Lung; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D011006:Pneumatosis Cystoides Intestinalis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib