Fluorouracil (5-FU) is a commonly used chemotherapeutic agent for a variety of tumor types, intravenously. Although capecitabine and tegafut, 5-FU oral prodrugs, induce rarely paralytic ileus, this particular intestinal toxicity has never been attributed to 5-FU. Paralytic ileus (or adynamic ileus) refers to a lack of passage of intestinal contents due to disturbances of normal intestinal motility, in absence of mechanical obstruction. A lot of anticancer drug, target-therapy drugs too, are the most common causes of this toxitity. The clinical case in local Lanciano Hospital we present is of a patient diagnosed as having colon cancer and he was admitted with paralytic ileus following adjuvant treatment with 5-FU (Mayo-clinic schedule). Naranjo, Jones algoritms suggest a direct casual relationship. Our case, to our knowledge, represents the first published report of this particular intestinal toxicity of 5-FU. Paralytic ileus is probably a rare complication of 5-FU and its oral prodrugs, but the oncologist should take it into careful consideration, because of his possible seriousness and because a correct management of early signs of abdominal distension (with nasogastric suction, i.v. infusion of fluids and electrolytes, rectal tube) can avoid a unnecessary surgical operation.
Paralytic ileus, a new rare complication of 5-FU: A case report
GRAPPASONNI, Iolanda;
2010-01-01
Abstract
Fluorouracil (5-FU) is a commonly used chemotherapeutic agent for a variety of tumor types, intravenously. Although capecitabine and tegafut, 5-FU oral prodrugs, induce rarely paralytic ileus, this particular intestinal toxicity has never been attributed to 5-FU. Paralytic ileus (or adynamic ileus) refers to a lack of passage of intestinal contents due to disturbances of normal intestinal motility, in absence of mechanical obstruction. A lot of anticancer drug, target-therapy drugs too, are the most common causes of this toxitity. The clinical case in local Lanciano Hospital we present is of a patient diagnosed as having colon cancer and he was admitted with paralytic ileus following adjuvant treatment with 5-FU (Mayo-clinic schedule). Naranjo, Jones algoritms suggest a direct casual relationship. Our case, to our knowledge, represents the first published report of this particular intestinal toxicity of 5-FU. Paralytic ileus is probably a rare complication of 5-FU and its oral prodrugs, but the oncologist should take it into careful consideration, because of his possible seriousness and because a correct management of early signs of abdominal distension (with nasogastric suction, i.v. infusion of fluids and electrolytes, rectal tube) can avoid a unnecessary surgical operation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
