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Review
. 2018 Aug 16;12(1):221.
doi: 10.1186/s13256-018-1759-z.

Rectal perforation following paclitaxel and carboplatin chemotherapy for advanced ovarian cancer: a case report and review of the literature

Sujen Jayakody  1 , Danette Bianca Wright  2 , Corrina Chiong  2 , Mona Liu  2 , Clare Bouffler  2 , Toufic El-Khoury  2
Affiliations
Review

Rectal perforation following paclitaxel and carboplatin chemotherapy for advanced ovarian cancer: a case report and review of the literature

Sujen Jayakody et al. J Med Case Rep. .

Abstract

Background: Paclitaxel is a chemotherapy drug commonly used in the management of ovarian cancer. Colonic perforation is an extremely rare complication of paclitaxel administration with few case reports in the medical literature. We report a case of a patient with advanced ovarian cancer who had a rectal perforation following administration of paclitaxel. There has only been one other case report of rectal perforation in the medical literature following paclitaxel therapy.

Case presentation: A 55-year-old Caucasian woman with advanced ovarian cancer awaiting elective debulking surgery for her tumor presented to our emergency department with abdominal pain, vomiting, and diarrhea. She was admitted to hospital for neoadjuvant chemotherapy and management of her systemic symptoms. She became acutely unwell following one cycle of chemotherapy with paclitaxel. A computed tomography scan of her abdomen showed typhlitis of her descending colon and a corresponding rectal perforation. Surgical intervention was deemed inappropriate as she had a heavy burden of disease and neutropenia. She died following a period of conservative management with strong intravenously administered antibiotics.

Conclusions: This case highlights the importance of recognizing gastrointestinal complications following chemotherapy and the need to be aware of the possibility of bowel perforation. Prompt surgical review and intervention must be requested in patients with acute abdominal pain and persistent gastrointestinal symptoms such as diarrhea and vomiting.

Keywords: Chemotherapy; Paclitaxel; Rectal perforation.

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Conflict of interest statement

Consent for publication

Written informed consent was obtained from the patient’s next of kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Rectal pneumatosis. Air is present in the wall of the rectum as indicated by arrows on coronal section of computed tomography scan of the pelvis
Fig. 2
Fig. 2
Rectal perforation. Free air is present outside the rectum as indicated by arrows on sagittal section of computed tomography scan of the pelvis
See this image and copyright information in PMC

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