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Case Reports
. 2008 May 28;14(20):3273-5.
doi: 10.3748/wjg.14.3273.

Pneumatosis cystoides intestinalis after fluorouracil chemotherapy for rectal cancer

Kenji Mimatsu  1 , Takatsugu Oida, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, Osamu Aramaki, Sadao Amano
Affiliations
Case Reports

Pneumatosis cystoides intestinalis after fluorouracil chemotherapy for rectal cancer

Kenji Mimatsu et al. World J Gastroenterol. .

Abstract

Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract. Several chemotherapeutic agents have been reported to be associated with PCI, although fluorouracil-related PCI is extremely rare. We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV). After 1 cycle of the treatment, he presented with diarrhea and abdominal pain. Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine. Laparotomy was performed, showing a suspected diagnosis of perforation in the gastrointestinal tract. Intraoperative findings revealed penumatosis of the intestine without evidence of perforation. He was treated supportively and his symptoms improved. In conclusion, we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.

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Figures

Figure 1
Figure 1
Abdominal radiogram showing intraluminal gases in the entire small intestine and free air under the diaphragm.
Figure 2
Figure 2
Abdominal CT scan showing excessive intraluminal gases in the entire small intestine and free air in the retroperitoneal space (A), and free air in the falciform ligament (B).
Figure 3
Figure 3
Expanded intraluminal air spaces in the small intestine and mesenterium during intra-operation.
See this image and copyright information in PMC

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