Okamoto T, Noguchi Y, Yoshikawa T, Nomura K, Fukuzawa K, Uranaka Y, Makino T, Tsuburaya A, Amano T, Matsumoto A
First Dept. of Surgery, Yokohama City University School of Medicine.
Gan To Kagaku Ryoho. 1994 Jul;21(8):1279-82.
We encountered two chemotherapy (CDDP and 5-FU) cases related to mesenteric thrombotic occlusion. Case 1 was a 26 yo male with adrenal carcinoma recurrence. He had been treated by CDDP and 5-FU. Five days after completion of the second course, he suffered from acute abdomen. Laparotomy revealed thrombotic occlusion of the superior mesenteric artery. Most of the small intestine and a part of the ascending colon were necrotic. Case 2 was a 60 yo female with lung and hepatic metastasis from uretal tumor. CDDP based chemotherapy was initiated. Severe abdominal pain and melena occurred one day after completion of the second course of chemotherapy. The inferior mesenteric artery was occluded and the descending colon was necrotic. Recently, a variety of chemotherapy-induced vascular lesions, including thrombotic microangiopathy, myocardial infarction and cerebral infarction, have been reported. CDDP and 5-FU were shown to be related to the acute thrombotic occlusion of the major vessels. Although the incidence is rare, the prognosis is poor. Acute vascular obstruction should be taken into consideration as a possible course of chemotherapy-related complications.
我们遇到了两例与肠系膜血栓性闭塞相关的化疗（顺铂和5-氟尿嘧啶）病例。病例1是一名26岁的男性，患有肾上腺癌复发。他接受了顺铂和5-氟尿嘧啶治疗。在完成第二个疗程后的第五天，他出现了急腹症。剖腹探查显示肠系膜上动脉血栓性闭塞。大部分小肠和一部分升结肠坏死。病例2是一名60岁的女性，患有输尿管肿瘤的肺和肝转移。开始了以顺铂为基础的化疗。在完成第二个化疗疗程后的一天，出现了严重的腹痛和黑便。肠系膜下动脉闭塞，降结肠坏死。最近，已经报道了多种化疗引起的血管病变，包括血栓性微血管病、心肌梗死和脑梗死。顺铂和5-氟尿嘧啶被证明与主要血管的急性血栓性闭塞有关。虽然发病率很低，但预后很差。急性血管阻塞应被视为化疗相关并发症的一种可能情况。
