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Enterocutaneous Fistula: A Challenging Complication in Cervical Cancer Management.
Abigayle Wyer1, Mena Louis2, Oluwasemilore I Okunlola2
1Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Cureus
|August 7, 2025
Summary
Bevacizumab therapy can cause severe enterocutaneous fistulas, especially after pelvic surgery. Early detection and multidisciplinary care are crucial for managing this serious complication in cancer patients.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Complications
Background:
- Bevacizumab, an anti-angiogenic drug, is used in cancer treatment.
- Prior pelvic surgery or radiation increases risks associated with bevacizumab.
Observation:
- A patient developed a severe enterocutaneous fistula with an abscess after bevacizumab therapy and prior pelvic surgery.
- The fistula presented as feculent drainage from a thigh incision, confirmed by imaging and cultures.
Findings:
- Bevacizumab disrupts angiogenesis and tissue repair, leading to fistula formation.
- Surgical intervention provided temporary relief, but conservative management was key for stabilization.
- Intestinal flora confirmed the bowel origin of the infection.
Implications:
- Bevacizumab therapy carries a significant risk of fistula formation, particularly in patients with a history of pelvic treatments.
- Prompt diagnosis through clinical suspicion and imaging is vital.
- Multidisciplinary management is essential for effective treatment of bevacizumab-induced fistulas.
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