Erosive gastroduodenitis with marked epithelial atypia after hepatic arterial infusion chemotherapy

We report the case of a 59-year-old man who was treated with intraarterial chemotherapy for metastatic colonic adenocarcinoma. After the second course he developed persistent symptoms of nausea, vomiting, and pain. Endoscopic examination demonstrated severe erosive gastritis and duodenitis, and histological examination of the antral tissue showed severe atypia and histological appearances suggestive of in situ carcinoma. A 2-month course of sucralfate and cimetidine was used and successfully produced symptomatic relief as well as complete normalization of the dysplastic changes.