A Case of Typhlitis Developed after Chemotherapy with Irinotecan and Cisplatin in a Patient with Small Cell Lung Carcinoma

Abstract

Typhlitis is a necrotizing colitis that usually occurs in neutropenic patients and develops most often in patients with hematologic malignancies such as leukemia and lymphoma. Typhlitis may proceed to bowel perforation, peritonitis and sepsis, which requires immediate treatment. Irinotecan is a semisynthetic analogue of the natural alkaloid camptothecin which prevents DNA from unwinding by inhibition of topoisomerase I. It is mainly used in colon cancer and small cell lung carcinoma (SCLC), of which the most common adverse effects are gastrointestinal toxicities. To the best of our knowledge, no case of typhlitis after chemotherapy with a standard dose of irinotecan in a solid tumor has been reported in the literature. We, herein, report the first case of typhlitis developed after chemotherapy combining irinotecan and cisplatin in a patient with SCLC.

Severe Colitis Caused by Hepatic Arterial Infusion Chemotherapy with Cisplatin for Hepatocellular Carcinoma

“…The most common adverse effects of cisplatin used for HAIC are renal toxicity and cy-topenia (15,16). Although general chemotherapy with cisplatin is known to occasionally cause colitis (particularly neutropenic colitis) (6,8), no report has described colitis secondary to HAIC with cisplatin because the dosage of cisplatin used for HAIC is relatively small. Chemotherapy-induced gastrointestinal is a common complication observed in patients with cancer.…”

“…Neutropenic enterocolitis, ischemic colitis, and pseudomembranous colitis are the specific types of colitis that occur as adverse effects of chemotherapy. Neutropenic colitis occurs in any patient with significant neutropenia, which commonly occurs during the third week after receiving cytotoxic chemotherapy (6,8,17). Ischemic colitis has been reported with the administration of docetaxel-or gemcitabine-containing regimens, which manifests as blood-stained stool and intestinal necrosis on a colonoscopic examination (3)(4)(5).…”

“…Chemotherapy-induced gastrointestinal toxicity is a common complication in patients with cancer (1)(2)(3)(4)(5)(6)(7). Neutropenic enterocolitis, ischemic colitis, and pseudomembranous colitis are the specific types of colitis that are known complications of chemotherapy (3)(4)(5)(6)(7)(8). In Japan, a fine-powder formulation of cisplatin is commonly used to administer hepatic arterial infusion chemotherapy (HAIC) for transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC) (9,10).…”

“…In Japan, a fine-powder formulation of cisplatin is commonly used to administer hepatic arterial infusion chemotherapy (HAIC) for transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC) (9,10). General chemotherapy with cisplatin may occasionally cause colitis (particularly neutropenic colitis) (6,8); however, no report has described colitis secondary to HAIC with cisplatin because the dosage of cisplatin used for HAIC is relatively small.…”

Primary cecal pathologies presenting as acute abdomen and critical appraisal of their current management strategies in emergency settings with review of literature

“…Only certain group of patients with cecal acute abdomen can be managed conservatively. These include certain patients with localized retrocecal abscess which can be aspirated using imaging studies,[ 51 ] typhlitis responding to medications,[ 52 ] amebic colitis with or without liver abscess,[ 3 5 ] certain cases of cecal diverticulitis,[ 53 ] and old debilitated patients in whom surgical outcome is expected to be very poor. We also managed five patients conservatively.…”