Severe intestinal ischemia during chemotherapy for small cell lung cancer

Thromboembolic events (TEEs) are frequent in cancer patients, especially venous thrombosis. Arterial thrombosis is less frequent. Chemotherapy increases the risk of these TEEs. Although TEEs are often reported, intestinal ischemia is a rare complication in cancer patients treated with chemotherapy. Here we describe a rare case of a patient with small cell lung cancer, who developed intestinal ischemia during treatment with cisplatin-etoposide chemotherapy. Shock and multiple organ failure developed and an urgent laparotomy with total colectomy was necessary. This case and review of the literature show that overall arterial TEEs are not as infrequent and may rarely manifest as intestinal ischemia. A cardiovascular assessment before the start of anticancer therapy is therefore imperative for cancer patients.