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Published on: May 11, 2011
Early small bowel perforation due to aflibercept
Toufic Moussallem1, Chetana Lim1, Michael Osseis1
1Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Henri Mondor Hospital.
Abstract:
In patients with malignancy who receive aflibercept based chemotherapy, gastrointestinal perforation is among the reported adverse events with a prevalence of 1.9%. This complication may lead to mortality up to 10.8%. We here report a case of small bowel perforation that occurred fifteen days after the first cycle of aflibercept in a 58-year old female who had metachronous colorectal liver metastases. Emergency laparotomy was performed and revealed a small bowel perforation without any anastomotic dehiscence. Surgery was followed by uneventful outcome. The use of aflibercept in patients with malignancy may be associated with very early gastrointestinal perforation and this should be known by oncologist and surgeons.
Insights
Gastrointestinal perforation is a rare but serious adverse event in patients receiving aflibercept chemotherapy. Early recognition and surgical intervention are crucial for managing this potentially fatal complication.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Aflibercept is a vascular endothelial growth factor (VEGF) inhibitor used in cancer therapy.
- Gastrointestinal perforation is a known, albeit uncommon, adverse event associated with aflibercept treatment.
- The reported incidence of gastrointestinal perforation is 1.9%, with a mortality rate up to 10.8%.
Observation:
- A case report of a 58-year-old female patient with metachronous colorectal liver metastases is presented.
- The patient developed a small bowel perforation 15 days after her first cycle of aflibercept-based chemotherapy.
- Emergency laparotomy confirmed the small bowel perforation, with no evidence of anastomotic leak.
Findings:
- This case highlights the potential for very early onset of gastrointestinal perforation following aflibercept initiation.
- Despite the severity, the patient experienced an uneventful recovery after surgical intervention.
Implications:
- Oncologists and surgeons should be aware of the risk of early gastrointestinal perforation in patients treated with aflibercept.
- Vigilance for this adverse event is essential for timely diagnosis and management.
- This underscores the importance of multidisciplinary communication in managing cancer patients receiving targeted therapies.
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