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Case Reports
. 2017 Nov 21;2017(11):rjx227.
doi: 10.1093/jscr/rjx227. eCollection 2017 Nov.

A case of pneumatosis intestinalis during neoadjuvant chemotherapy with cisplatin and 5-fluorouracil for esophageal cancer†

Keita Kouzu  1 , Hironori Tsujimoto  1 , Shuichi Hiraki  1 , Risa Takahata  1 , Yoshihisa Yaguchi  1 , Isao Kumano  1 , Hiroyuki Horiguchi  1 , Shinsuke Nomura  1 , Ken Nagata  1 , Manabu Harada  1 , Hiromi Nagata  1 , Takao Sugihara  1 , Yusuke Ishibashi  1 , Yujiro Itazaki  1 , Satoshi Tsuchiya  1 , Suefumi Aosasa  1 , Kazuo Hase  1 , Junji Yamamoto  1 , Hideki Ueno  1
Affiliations
Case Reports

A case of pneumatosis intestinalis during neoadjuvant chemotherapy with cisplatin and 5-fluorouracil for esophageal cancer†

Keita Kouzu et al. J Surg Case Rep. .

Abstract

Pneumatosis intestinalis (PI) is a relatively rare disease. A 70-year-old man with stage II squamous cell carcinoma of the middle thoracic esophagus was administered cisplatin plus 5-fluorouracil (CF) therapy as neoadjuvant chemotherapy. On Day 14 of the first course of CF therapy, he complained of acute abdominal pain. Computed tomography (CT) revealed PI of the entire colon and a small air bubble in the mesentery. A colonoscopy revealed that there was no finding suggestive of ischemia. Because there was no sign of peritoneal irritation, conservative treatment was selected. On Day 7 after PI diagnosis, CT indicated the disappearance of PI. The patient underwent a radical esophagectomy. Intraoperative laparoscopic findings showed the serosa of the colon to be intact. The patient was discharged without any complications. It is important to take into account that CF therapy may cause PI and that PI can be treated conservatively.

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Figures

Figure 1:
Figure 1:
Abdominal computed tomography at the onset of abdominal pain revealed pneumatosis intestinalis of the colon. No free air was detected (A). Computed tomography 7 days after the diagnosis of pneumatosis intestinalis did not show any gas within the wall of colon (B).
Figure 2:
Figure 2:
Colonoscopy at the onset of abdominal pain. In colonoscopy on the day of onset of pneumatosis intestinalis, the edema of the mucous membrane and white coat were observed.
See this image and copyright information in PMC

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