Ichimaru Toshimitsu, Sakamoto Takamitsu, Amagai Teruyoshi
Department of Gastroenterology Fukuoka Tokushukai General Hospital Fukuoka Japan.
Department of Clinical Engineering Faculty of Health Care Sciences Jikei University of Health Care Sciences Osaka Japan.
DEN Open. 2025 Mar 29;5(1):e70109. doi: 10.1002/deo2.70109. eCollection 2025 Apr.
A 77-year-old woman with stage IVB gastric adenocarcinoma (cT4N2M1) received 10 cycles of S-1, oxaliplatin, and nivolumab combination chemotherapy. Imaging and biopsy confirmed a complete response. However, thrombocytopenia, mild splenomegaly, and elevated liver enzymes developed following oxaliplatin administration. After the tenth cycle, a contrast-enhanced computed tomography scan revealed a portosystemic shunt. Oxaliplatin was discontinued, but the shunt persisted after 1 year. Balloon-occluded retrograde transvenous obliteration was successfully performed, resulting in the resolution of the shunt. This case highlights the potential for oxaliplatin-induced portal hypertension requiring close monitoring.
一名77岁的IVB期胃腺癌（cT4N2M1）女性接受了10个周期的S-1、奥沙利铂和纳武单抗联合化疗。影像学检查和活检证实完全缓解。然而，在使用奥沙利铂后出现了血小板减少、轻度脾肿大和肝酶升高。在第10个周期后，增强计算机断层扫描显示存在门体分流。停用奥沙利铂，但分流在1年后仍然存在。成功进行了球囊闭塞逆行静脉栓塞术，分流得以消除。该病例突出了奥沙利铂诱导门静脉高压的可能性，需要密切监测。
