[Gastrointestinal toxicity caused by irinotecan in the case of preexistent passage problems]

Two female patients, aged 50 and 62 years respectively, who were treated with irinotecan, fluorouracil and folinic acid (Saltz scheme) due to metastasised colorectal carcinoma, developed progressive abdominal pain, fever and leucopenia. One patient also exhibited intestinal obstruction. The main problem was differentiating between an acute abdomen and irinotecan toxicity. Both patients recovered without the need for an operative intervention. One patient was treated by means of colonic stent placement. The combination of gastrointestinal irinotecan toxicity and pre-existing passage problems is dangerous. However, in such cases restraint should be exercised with respect to operative interventions.