A Case of Perforation of the Colon during the Chemotherapy with Irinotecan

Kazunori Kamiya^{1) 2)}, Michinori Hashimoto^{1) 2)}, Toru Kono²⁾, Takashige Saito¹⁾ and Shinichi Kasai²⁾

Department of Surgery, Higashiasahikawa Hospital¹⁾
Second Department of Surgery, Asahikawa Medical College²⁾

A 65-year-old woman who underwent sigmoidectomy for colon perforation with peritonitis due to sigmoid colon cancer on October 22, 1999, was treated 2 years and 5 months postoperatively with systemic chemotherapy with irinotecan due to suspected tumor recurrence suggested by increased serum CEA. On October 18, 2002, during cycle 7 of treatment, she was admitted for pain in the left lumbar region and fever. Abdominal CT and colonoscopy showed perforation of the left side transverse colon and an abscess in the retroperitoneal cavity. She then underwent abscess drainage and colostomy on October 24. About one year there after, colonoscopy showed healing of the injured colon. Perforation of the intestine during chemotherapy with irinotecan is rare, with only 9 patients, including ours, reported. Sufficient observation is thus required to determine perforation of the intestines in retarded bowel movement during chemotherapy with irinotecan.

Key words
CPT-11, intestinal perforation, retroperitoneal abscess

Reprint requests
Kazunori Kamiya Department of Surgery, Karasawa Hospital
4 Jodori 9, Asahikawa, 070-0034 JAPAN

Accepted
September 22, 2004

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