Sigmoid Perforation Following Radiation Therapy in Patients with Cervical Cancer

Ramírez, Pedro T.; Levenback, Charles; Burke, Thomas W.; Eifel, Patricia J.; Wolf, Judith K.; Gershenson, David M.

doi:10.1006/gyno.2001.6213

Cited by 24 publications

(22 citation statements)

References 21 publications

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“…Following hysterectomy, it may be hypothesized that bowel may be more likely to be exposed to radiation treatment. The effects of radiation exposure to large bowel during whole pelvic treatment have been well characterized, and cases of bowel perforation have been reported (Ramirez et al, 2001). However, the effects of vaginal cuff brachytherapy on the bowel are believed to be minimal.…”

Section: Discussionmentioning

confidence: 98%

Small bowel perforation 17months after robotic surgery for endometrial cancer: A case report

Faro

Graybill

Tung

et al. 2012

Gynecologic Oncology Case Reports

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Section: Discussionmentioning

confidence: 98%

Small bowel perforation 17months after robotic surgery for endometrial cancer: A case report

Faro

Graybill

Tung

et al. 2012

Gynecologic Oncology Case Reports

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“…Im [3,10,11,12].Die idiopathische Sigmaperforation entsteht durch ein zeitliches Zusammentreffen von Bauchpresse und erhöhtem Darminnendruck.Stark eingedickte Faeces und eine länger bestehende Obstipation begünstigen die Entstehung einer intestinalen Ruptur [5].Systemische Medikamentengaben und Bestrahlungstherapien können ebenfalls zu einer nichttraumatischen Verletzung des Darms führen [8,13].…”

Section: Zusammenfassungunclassified

Sigmaperforation mit lokaler Peritonitis durch indirektes Trauma - Fallbericht und Literatur�bersicht

et al. 2003

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Injuries to the sigmoid occur either as acute or protracted events. In the first case, enteral contents discharge into the abdominal cavity and a generalized, fecal, life-threatening peritonitis with a bad prognosis develops. In the protracted form, the rupture is covered by peritoneum and adherent organs before perforation. The ensuing abscess formation may lead to perforation into contiguous visceral organs or the cutis. Frequently an intestinal or cutaneous fistula results. The trigger for a sigmoid perforation can be a spontaneous rupture in an already vulnerable intestine. Common precursory diseases are diverticulitis, colitis, carcinomas, and necroses. Also, elevated intestinal pressure invoked by increased bearing down or coproliths may cause disruption. Diagnostic procedures such as rectoscopy and rectal contrast instillation are frequent idiopathic causes of traumatic injuries to the sigmoid. Perforating injuries of the abdominal cavity by stabbing, gunshot, or impalement may affect the sigmoid and open its lumen. Foreign bodies often lead to traumatic injuries of the rectosigmoid junction. In contrast, indirect trauma as a cause of sigmoid perforation, which is described in the following case, is very rare. A 62-year-old woman,who had a cholecystectomy and adhesive strangulation of intestine in her history, was admitted to our clinic after falling down stairs and landing on her bottom. She suffered a sigmoid rupture and peritonitis. Laparotomy and suturing of the sigmoid defect were performed.

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“…In addition, the life expectancy of some may already be limited due to an extensive cancer burden that has been treated with multiple chemotherapy regimens. A few studies, including one from our own institution, have evaluated the outcomes in gynecologic oncology patients diagnosed with bowel injury [3-5]. The previous studies have suggested that prognosis is poor in such patients and that management approaches should be carefully considered.…”

Section: Introductionmentioning

confidence: 99%

Intestinal perforation in gynecologic oncology: Do all patients benefit from surgical management?

Garg

Massad

Pourabolghasem

et al. 2013

Gynecologic Oncology

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Objective To identify those patients with gynecologic cancers and intestinal perforation in whom conservative management may be appropriate. Methods A retrospective review was performed of all gynecologic oncology patients with intestinal perforation at our institution between 1995 and 2011. The Kaplan-Meier method and Cox proportional hazards models were used to analyze factors influencing survival. Results Forty-three patients met the study criteria. The mean age was 59 years (range: 38-82 years). A large number of patients had peritoneal carcinomatosis and history of bowel obstruction. Surgery was performed in 28 patients, and 15 were managed conservatively. Overall mortality at 1, 3, 6, and 12 months was 26%, 40%, 47%, and 59%, respectively. Only cancer burden at the time of perforation was independently predictive of mortality. Patients with peritoneal carcinomatosis, distant metastasis, or both were at 42 times higher risk of death than those with no evidence of disease (95% CI: 3.28-639.83), and at 7 times higher risk of death than those with microscopic/localized disease (95% CI: 1.77-29.94). When adjusted for the extent of disease spread, management approach (conservative vs. surgical) was not a significant predictor of survival (p≥0.05). The length of hospital stay (19 days vs. 7 days) and the complication rate (75% vs. 26.7%) were significantly higher in the surgical group than in the non-surgical group (p<0.05). Conclusions Patients who develop intestinal perforation in the setting of widely metastatic disease have a particularly poor prognosis. Aggressive surgical management is unlikely to benefit such patients and further impairs their quality of life.

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Sigmoid Perforation Following Radiation Therapy in Patients with Cervical Cancer

Cited by 24 publications

References 21 publications

Small bowel perforation 17months after robotic surgery for endometrial cancer: A case report

Small bowel perforation 17months after robotic surgery for endometrial cancer: A case report

Sigmaperforation mit lokaler Peritonitis durch indirektes Trauma - Fallbericht und Literatur�bersicht

Intestinal perforation in gynecologic oncology: Do all patients benefit from surgical management?

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