Yamamoto Shumpei, Onishi Hideki, Oyama Atsushi, Takaki Akinobu, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.
Intern Med. 2020 Jan 1;59(1):69-75. doi: 10.2169/internalmedicine.3340-19. Epub 2019 Sep 3.
A 78-year-old man with chronic hepatitis C underwent hepatectomy for hepatocellular carcinoma (HCC) 11 years prior to presentation. He was diagnosed with multiple intrahepatic recurrences of HCC with portal vein invasion and received hepatic arterial infusion chemotherapy (HAIC) with cisplatin. He developed abdominal pain, diarrhea, and blood-stained stool following treatment. Computed tomography revealed significant bowel wall thickening throughout the colon. Colonoscopy revealed reddish edematous mucosa with a reduced vascular pattern without ischemic changes. Conservative treatment with total parenteral nutrition improved his condition and his imaging findings. This is the first report of severe colitis following HAIC with cisplatin.
一名78岁的慢性丙型肝炎男性患者在就诊前11年因肝细胞癌(HCC)接受了肝切除术。他被诊断为HCC多发肝内复发伴门静脉侵犯,并接受了顺铂肝动脉灌注化疗(HAIC)。治疗后,他出现腹痛、腹泻和便血。计算机断层扫描显示整个结肠肠壁显著增厚。结肠镜检查显示黏膜呈红色水肿,血管纹理减少,无缺血改变。全胃肠外营养保守治疗改善了他的病情和影像学表现。这是首例关于顺铂HAIC治疗后发生严重结肠炎的报告。