Skip to main content
Top
Published in: Digestive Diseases and Sciences 1/2008

01-01-2008

Pneumatosis Intestinalis and Portal Venous Gas Without Bowel Ischemia in a Patient Treated with Irinotecan and Cisplatin

Authors: David Kung, Daniel T Ruan, Rodney K. Chan, Melissa L. Ericsson, Mandeep S. Saund

Published in: Digestive Diseases and Sciences | Issue 1/2008

Login to get access

Abstract

Pneumatosis intestinalis and gas within the portal venous system are findings predictive of bowel ischemia. The etiologies of these alarming radiographic signs are diverse and not all causes require emergent surgical intervention. The combination of pneumatosis intestinalis, portal venous gas, and acidosis typically portends bowel ischemia and inevitable necrosis. This case report is the first description of benign pneumatosis and portal venous gas secondary to irinotecan and cisplatin.
Literature
1.
go back to reference Schulze CG, Blum U, Haag K (1995) Hepatic portal venous gas: imaging modalities and clinical significance. Acta Radiol 36:377–380PubMedCrossRef Schulze CG, Blum U, Haag K (1995) Hepatic portal venous gas: imaging modalities and clinical significance. Acta Radiol 36:377–380PubMedCrossRef
2.
go back to reference Kernagis LY, Levine MS, Jacobs JE (2003) Pneumatosis intestinalis in patients with ischemia: correlation of CT findings with viability of the bowel. AJR Am J Roentgenol 180:733–736PubMed Kernagis LY, Levine MS, Jacobs JE (2003) Pneumatosis intestinalis in patients with ischemia: correlation of CT findings with viability of the bowel. AJR Am J Roentgenol 180:733–736PubMed
3.
go back to reference Rha SE, Ha HK, Lee SH, Kim JH, Kim JK, Kim JH, Kim PN, Lee MG, Auh YH (2000) CT and MR imaging findings of bowel ischemia from various primary causes. Radiographics 20:29–42PubMed Rha SE, Ha HK, Lee SH, Kim JH, Kim JK, Kim JH, Kim PN, Lee MG, Auh YH (2000) CT and MR imaging findings of bowel ischemia from various primary causes. Radiographics 20:29–42PubMed
4.
go back to reference Galm O, Fabry U, Adam G, Osieka R (2001) Pneumatosis intestinalis following cytotoxic or immunosuppressive treatment. Digestion 64:128–132PubMedCrossRef Galm O, Fabry U, Adam G, Osieka R (2001) Pneumatosis intestinalis following cytotoxic or immunosuppressive treatment. Digestion 64:128–132PubMedCrossRef
5.
go back to reference Peloponissios N, Halkic N, Pugnale M, Jornod P, Nordback P, Meyer A, Gillet M (2003) Hepatic portal gas in adults. Arch Surg 138:1367–1370PubMedCrossRef Peloponissios N, Halkic N, Pugnale M, Jornod P, Nordback P, Meyer A, Gillet M (2003) Hepatic portal gas in adults. Arch Surg 138:1367–1370PubMedCrossRef
6.
go back to reference Knechtle SJ, Davidoff AM, Rice RP (1990) Pneumatosis intestinalis: surgical management and clinical outcome. Ann Surg 212:160–165PubMedCrossRef Knechtle SJ, Davidoff AM, Rice RP (1990) Pneumatosis intestinalis: surgical management and clinical outcome. Ann Surg 212:160–165PubMedCrossRef
7.
go back to reference Liebman PR, Patten MT, Manny J, Benfield JR, Hechtman HB (1978) Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg 187:281–287PubMedCrossRef Liebman PR, Patten MT, Manny J, Benfield JR, Hechtman HB (1978) Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg 187:281–287PubMedCrossRef
9.
go back to reference Wiesner W, Mortele KJ, Glickman JN, Ji H, Ros PR (2001) Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. AJR Am J Roentgenol. 177:1319–1323PubMed Wiesner W, Mortele KJ, Glickman JN, Ji H, Ros PR (2001) Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. AJR Am J Roentgenol. 177:1319–1323PubMed
10.
go back to reference Alimonti A, Gelibter A, Pavese I, Satta F, Cognetti F, Ferretti G, Rasio D, Vecchione A, Di Palma M (2004) New approaches to prevent intestinal toxicity of irinotecan-based regimens. Cancer Treat Rev 30:555–562PubMedCrossRef Alimonti A, Gelibter A, Pavese I, Satta F, Cognetti F, Ferretti G, Rasio D, Vecchione A, Di Palma M (2004) New approaches to prevent intestinal toxicity of irinotecan-based regimens. Cancer Treat Rev 30:555–562PubMedCrossRef
11.
go back to reference Rothenberg M (2001) Irenotecan (CPT-11): recent developments and future directions–colorectal cancer and beyond. Oncologist 6:66–80PubMedCrossRef Rothenberg M (2001) Irenotecan (CPT-11): recent developments and future directions–colorectal cancer and beyond. Oncologist 6:66–80PubMedCrossRef
12.
go back to reference Van Huyen JPD, Bloch F, Attar A, Levoir D, Kreft C, Molina T, Bruneval P (1998) Duffuse mucosal damage in the large intestine associated with irinotecan. Dig Dis Sci 43:2649–2651PubMedCrossRef Van Huyen JPD, Bloch F, Attar A, Levoir D, Kreft C, Molina T, Bruneval P (1998) Duffuse mucosal damage in the large intestine associated with irinotecan. Dig Dis Sci 43:2649–2651PubMedCrossRef
13.
go back to reference Araki E, Ishikawa M, Iigo M, Koide T, Itabashi M, Hoshi A (1993) Relationship between development of diarrhea and the concentration of SN-38, an active metabolite of CPT-11, in the intestine and the blood plasma of athymic mice following intraperitoneal administration of CPT-11. Jpn J Cancer Res 84:697–702PubMed Araki E, Ishikawa M, Iigo M, Koide T, Itabashi M, Hoshi A (1993) Relationship between development of diarrhea and the concentration of SN-38, an active metabolite of CPT-11, in the intestine and the blood plasma of athymic mice following intraperitoneal administration of CPT-11. Jpn J Cancer Res 84:697–702PubMed
14.
go back to reference Sandmeier D, Chaubert P, Bouzourene H (2005) Irinotecan-induced colitis. Int J Surg Pathol 13:215–218PubMedCrossRef Sandmeier D, Chaubert P, Bouzourene H (2005) Irinotecan-induced colitis. Int J Surg Pathol 13:215–218PubMedCrossRef
15.
go back to reference Fuertes MA, Castilla J, Alonso C, Pérez JM (2003) Cisplatin biochemical mechanism of action: from cytotoxicity to induction of cell death through interconnections between apoptotic and necrotic pathways. Curr Med Chem 10:257–266 Fuertes MA, Castilla J, Alonso C, Pérez JM (2003) Cisplatin biochemical mechanism of action: from cytotoxicity to induction of cell death through interconnections between apoptotic and necrotic pathways. Curr Med Chem 10:257–266
16.
go back to reference Noda K, Nishiwaki Y, Kawahara M, Negoro S, Sugiura T, Yokoyama A, Fukuoka M, Mori K, Watanabe K, Tamura T, Yamamoto S, Saijo N (2002) Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. New Engl J Med 346:85–91PubMedCrossRef Noda K, Nishiwaki Y, Kawahara M, Negoro S, Sugiura T, Yokoyama A, Fukuoka M, Mori K, Watanabe K, Tamura T, Yamamoto S, Saijo N (2002) Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. New Engl J Med 346:85–91PubMedCrossRef
17.
go back to reference Tan HL, Tantoco JG, Ee MZ (2007) The role of diagnostic laparoscopy in micropremmies with suspected necrotizing enterocolitis. Surg Endosc 21:485–487PubMedCrossRef Tan HL, Tantoco JG, Ee MZ (2007) The role of diagnostic laparoscopy in micropremmies with suspected necrotizing enterocolitis. Surg Endosc 21:485–487PubMedCrossRef
Metadata
Title
Pneumatosis Intestinalis and Portal Venous Gas Without Bowel Ischemia in a Patient Treated with Irinotecan and Cisplatin
Authors
David Kung
Daniel T Ruan
Rodney K. Chan
Melissa L. Ericsson
Mandeep S. Saund
Publication date
01-01-2008
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 1/2008
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-007-9846-9

Other articles of this Issue 1/2008

Digestive Diseases and Sciences 1/2008 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.