Tirumani Sree Harsha, Baez Juan C, Jagannathan Jyothi P, Shinagare Atul B, Ramaiya Nikhil H
Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA,
Abdom Imaging. 2013 Oct;38(5):1014-23. doi: 10.1007/s00261-013-9987-6.
Tumor-bowel fistula is an under reported complication of abdomino-pelvic malignancies which may occur spontaneously due to tumor growth or can be associated with cancer treatment. Chemotherapy and radiotherapy are commonly responsible for tumor-bowel fistulas. Molecular targeted therapies are a new class of drugs that can cause tumor fistulization due to their antiangiogenic properties. Clinically, the fistula can be asymptomatic or can result in devastating complications. Imaging helps in the prompt detection of these fistulas and the complications associated with them. Management of tumor-bowel fistula is individualized but often involves discontinuation of the associated treatment. Radiologists should promptly alert the oncology team about the presence of tumor-bowel fistula and any risk factors for its occurrence like pneumatosis or large metastatic deposits close to bowel loops.
肿瘤-肠瘘是腹盆腔恶性肿瘤一种报道较少的并发症，可能因肿瘤生长而自发出现，也可能与癌症治疗有关。化疗和放疗是导致肿瘤-肠瘘的常见原因。分子靶向治疗是一类新型药物，因其抗血管生成特性可导致肿瘤形成瘘管。临床上，瘘管可能无症状，也可能导致严重并发症。影像学有助于及时发现这些瘘管及其相关并发症。肿瘤-肠瘘的治疗是个体化的，但通常需要停止相关治疗。放射科医生应及时提醒肿瘤学团队注意肿瘤-肠瘘的存在及其发生的任何危险因素，如肠壁积气或靠近肠袢的大转移灶。
