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Intestinal Pseudo-Obstruction After Vincristine Use.

Miguel Monteiro1, Beatriz Castanheira2, Elsa Meireles3

  • 1Department of Intensive Care Medicine, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, PRT.

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|December 23, 2024
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Summary
This summary is machine-generated.

A 73-year-old man developed acute colonic pseudo-obstruction after starting vincristine chemotherapy for lymphoma. This rare side effect led to intestinal ileus, requiring intensive care.

Keywords:
chemoinduced neuropathylymphomaogilvie's syndromeparalytic ileusvincristine

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Area of Science:

  • Gastroenterology
  • Oncology
  • Pharmacology

Background:

  • Peripheral CD4+ T cell lymphoma is a rare hematologic malignancy.
  • Chemotherapy, including vincristine, is a standard treatment for lymphoma.
  • Gastrointestinal complications can occur during cancer treatment.

Observation:

  • A 73-year-old male patient with stage III peripheral CD4+ T cell lymphoma presented with symptoms of nausea, abdominal discomfort, and distention.
  • The patient had recently commenced chemotherapy with vincristine two weeks prior to symptom onset.
  • Clinical evaluation revealed diffuse colonic distention and pneumatosis intestinalis, indicative of acute colonic pseudo-obstruction without mechanical blockage.

Findings:

  • Vincristine-induced ileus was suspected as the primary cause of the patient's condition.
  • The pseudo-obstruction led to distributive shock, necessitating Intensive Care Unit admission.
  • Exclusion of other potential causative factors supported the diagnosis of vincristine-induced gastrointestinal toxicity.

Implications:

  • This case highlights a rare but serious adverse effect of vincristine, emphasizing the need for vigilant monitoring of gastrointestinal symptoms in patients undergoing chemotherapy.
  • Early recognition and management of vincristine-induced pseudo-obstruction are crucial to prevent severe complications such as bowel ischemia and shock.
  • Further research into the mechanisms of vincristine-induced gastrointestinal motility disorders may lead to improved preventative strategies and treatment options.