Onyirioha Kristeen, Balakrishnan Maya
Section of Gastroenterology and Hepatology, Department of Internal Medicine, Baylor College of Medicine, Houston, TX.
Center for Innovations in Quality, Effectiveness and Safety (IQuEST), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
ACG Case Rep J. 2025 Aug 1;12(8):e01780. doi: 10.14309/crj.0000000000001780. eCollection 2025 Aug.
A 58-year-old woman with endometrial cancer started on paclitaxel in combination with carboplatin chemotherapy, presented to the hospital with severe anemia and melena. An esophagogastroduodenoscopy with biopsies revealed diffuse gastric antrum hemorrhagic gastropathy without inflammatory changes. She had recurrent admissions with similar presentations during her chemotherapy. Her management included frequent blood transfusions, endoscopic Argon plasma coagulation to hemorrhagic lesions, and a prolonged course of proton pump inhibition to facilitate post-Argon plasma coagulation mucosal healing. Weeks after completing chemotherapy, her hemoglobin improved and recurrent upper gastrointestinal bleeding resolved. In this case, we identify a rare paclitaxel, in combination with carboplatin, associated hemorrhagic gastropathy with symptomatic, clinical, and endoscopic resolution seen only after completing chemotherapy.
一名58岁的子宫内膜癌女性患者开始接受紫杉醇联合卡铂化疗，因严重贫血和黑便入院。食管胃十二指肠镜检查及活检显示胃窦弥漫性出血性胃病，无炎症改变。她在化疗期间因类似症状反复入院。她的治疗措施包括频繁输血、对出血性病变进行内镜氩离子凝固术，以及长时间使用质子泵抑制剂以促进氩离子凝固术后黏膜愈合。化疗结束数周后，她的血红蛋白水平有所改善，反复出现的上消化道出血也得到解决。在本病例中，我们发现了一种罕见的情况，即紫杉醇联合卡铂导致出血性胃病，只有在化疗结束后症状、临床和内镜表现才得以缓解。
