一名接受联合化疗治疗食管胃交界部转移性癌的患者发生结肠破裂。病例报告及文献复习。
Colonic rupture in a patient on combination chemotherapy for metastasized carcinoma of the esophagogastric junction. Case report and review of the literature.
作者信息
Colucci Gianluca, Thaler Walter, Dejaco Hans, Marsoner Hansjörg, Grones Alexia
机构信息
Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Policlinico G. B. Rossi, Verona, Italy.
出版信息
Onkologie. 2005 Apr;28(4):204-6. doi: 10.1159/000084143. Epub 2005 Mar 31.
BACKGROUND
Cecal perforation due to neutropenic colitis is a known and described side effect of many chemotherapy regimens. We present a case of a patient with gastric adenocarcinoma who developed spontaneous cecal perforation during chemotherapy without the classic pattern of typhlitis.
CASE REPORT
A 58-year-old woman was on chemotherapy for an adenocarcinoma of the gastric junction, when she developed a cecal perforation. There was neither evidence for leucopenia nor for typhlitis. Laparotomy was performed and cecostomy was established using the perforated bowel. Postoperative course was uneventful. The patient died from tumor progression 8 months after the diagnosis was made.
CONCLUSION
There is no evidence for a connection between this event and chemotherapy treatment but neither can it be excluded. Even if unusual, colon toxicity could be a potential life-threatening complication associated with more drugs than usually thought.
背景
中性粒细胞减少性结肠炎导致的盲肠穿孔是许多化疗方案已知且已描述的副作用。我们报告一例胃腺癌患者，其在化疗期间发生自发性盲肠穿孔，且无典型的盲肠炎表现。
病例报告
一名58岁女性因胃交界腺癌接受化疗时发生盲肠穿孔。既没有白细胞减少的证据，也没有盲肠炎的证据。进行了剖腹手术，并利用穿孔的肠段行盲肠造口术。术后过程顺利。患者在确诊后8个月因肿瘤进展死亡。
结论
没有证据表明这一事件与化疗治疗之间存在关联，但也不能排除。即使不常见，结肠毒性可能是一种与比通常认为的更多药物相关的潜在危及生命的并发症。
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