Maeda Ai, Nakata Masao, Shimizu Katsuhiko, Yukawa Takuro, Saisho Shinsuke, Okita Riki
Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Department of General Surgery, Kawasaki Medical School, Okayama, Okayama, 700-8505, Japan.
World J Surg Oncol. 2016 Jun 29;14(1):175. doi: 10.1186/s12957-016-0926-1.
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.
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.
Although PI is extremely rare, physicians should be aware of the risk of PI in patients undergoing gefitinib therapy.
肠壁积气（PI）被定义为肠壁内存在气体，是一种相对罕见的表现。PI与多种病理状况和药物有关。尽管有报道称几种化疗药物和分子靶向治疗药物与PI有关，但很少有报告描述抗表皮生长因子受体药物吉非替尼（一种酪氨酸激酶抑制剂[TKI]）与PI之间的关联。本报告描述了一例吉非替尼治疗继发PI的病例。
一名80岁女性被诊断为复发性肺腺癌，在开始吉非替尼治疗后出现明显食欲减退、腹胀和便秘。腹部计算机断层扫描（CT）显示PI从小肠延伸至直肠。患者接受保守治疗，停用吉非替尼。随后，症状改善，随访腹部X线显示肠壁内气体减少。重新开始使用吉非替尼后，PI又出现了三次。
尽管PI极为罕见，但医生应意识到接受吉非替尼治疗的患者存在PI风险。
