Liu H, Hsieh CT, Sun JM. Pneumatosis intestinalis after systemic chemotherapy for colorectal cancer: A case report. World J Clin Cases 2022; 10(16): 5337-5342 [PMID: 35812692 DOI: 10.12998/wjcc.v10.i16.5337]
Corresponding Author of This Article
Jui-Ming Sun, MD, Director, Section of Neurosurgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, No. 539 Zhongxiao Road, East District, Chiayi City 600, Taiwan. 07178@cych.org.tw
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2022; 10(16): 5337-5342 Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5337
Pneumatosis intestinalis after systemic chemotherapy for colorectal cancer: A case report
Hsien Liu, Cheng-Ta Hsieh, Jui-Ming Sun
Hsien Liu, Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan
Cheng-Ta Hsieh, Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei 22174, Taiwan
Cheng-Ta Hsieh, Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
Cheng-Ta Hsieh, School of Medicine, National Tsing Hua University, Hsinchu City 300044, Taiwan
Jui-Ming Sun, Section of Neurosurgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
Jui-Ming Sun, Department of Biotechnology, Asia University, Taichung City 41354, Taiwan
Author contributions: Liu H and Hsieh CT drafted the manuscript; Liu H performed the surgery; Liu H collected the clinical data and performed the follow-up; Hsieh CT and Sun JM conducted the literature review; and Sun JM revised the manuscript critically for intellectual content; all authors have read and approved the final manuscript.
Informed consent statement: This case report was approved by the Institutional Review Board of Chi Mei Hospital in Taiwan (Applicant’s number: 11007-E01). The informed consent was waived.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jui-Ming Sun, MD, Director, Section of Neurosurgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, No. 539 Zhongxiao Road, East District, Chiayi City 600, Taiwan. 07178@cych.org.tw
Received: July 17, 2021 Peer-review started: July 17, 2021 First decision: October 3, 2021 Revised: October 20, 2021 Accepted: April 21, 2022 Article in press: April 21, 2022 Published online: June 6, 2022 Processing time: 320 Days and 8.7 Hours
Abstract
BACKGROUND
Pneumatosis intestinalis (PI), also known as intramural gas in the small intestine, is a rare condition encountered by patients with cancer after receiving chemotherapy.
CASE SUMMARY
A 78-year-old man with a history of colorectal cancer developed epigastric pain and diarrhea after receiving combination chemotherapy of fluorouracil, leucovorin, irinotecan, and cetuximab. Abdomen radiography revealed intramural air in the small intestinal wall. A computed tomography scan of the abdomen revealed the features of PI with air expanding into the mesentery. After surgery, the patient remained symptom-free throughout a 9 mo follow-up period during which he received chemotherapy of fluorouracil, leucovorin, and irinotecan.
CONCLUSION
Although chemotherapy-induced PI is rare among patients with cancer, the differential diagnosis of PI and fulminant complications (such as ischemia, infarction, and perforation of the gastrointestinal tract) should be conducted, in which case an urgent surgical intervention is required.
Core Tip: Pneumatosis intestinalis (PI) is a rare condition encountered by patients with cancer after receiving chemotherapy. The differential diagnosis of PI and chemotherapy-induced fulminant complications (such as ischemia, infarction, and perforation of the gastrointestinal tract) should be conducted, in which case an urgent surgical intervention is required.
