内容紹介
Summary
A 73-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. Two years after the operation, multiple lung metastasis was diagnosed and chemotherapy with bevacizumab, irinotecan, and TS-1Ⓡ was started in the patient. However, epigastric pain developed 73 days after the initial course of chemotherapy. Abdominal CT revealed duodenal perforation and generalized peritonitis. Emergency operation with omental patch closure was immediately performed. The patient was discharged 15 days after the emergency operation without any complication. This is an extremely rare case of bevacizumab-related duodenal perforation.
要旨
症例は73歳,男性。S状結腸癌に対して腹腔鏡下S状結腸切除術を施行し,術後2年の時点で多発肺転移を認め外来化学療法(bevacizumab+IRIS)を開始した。化学療法開始後73日目に突然の心窩部痛を自覚し来院した。CTにて十二指腸穿孔・汎発性腹膜炎と診断し,直ちに大網充填・被覆術を施行した。術後経過は良好で第15病日に退院となった。bevacizumab併用化学療法施行中に発症した十二指腸穿孔というまれな病態を経験したので報告する。
目次
A 73-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. Two years after the operation, multiple lung metastasis was diagnosed and chemotherapy with bevacizumab, irinotecan, and TS-1Ⓡ was started in the patient. However, epigastric pain developed 73 days after the initial course of chemotherapy. Abdominal CT revealed duodenal perforation and generalized peritonitis. Emergency operation with omental patch closure was immediately performed. The patient was discharged 15 days after the emergency operation without any complication. This is an extremely rare case of bevacizumab-related duodenal perforation.
要旨
症例は73歳,男性。S状結腸癌に対して腹腔鏡下S状結腸切除術を施行し,術後2年の時点で多発肺転移を認め外来化学療法(bevacizumab+IRIS)を開始した。化学療法開始後73日目に突然の心窩部痛を自覚し来院した。CTにて十二指腸穿孔・汎発性腹膜炎と診断し,直ちに大網充填・被覆術を施行した。術後経過は良好で第15病日に退院となった。bevacizumab併用化学療法施行中に発症した十二指腸穿孔というまれな病態を経験したので報告する。