Ischemic Colitis of the Transverse Colon Induced by 5-Fluorouracil, Leucovorin, and Irinotecan: A Case Report

Fezzeh Elyasinia; Nasir Fakhar; Reza Eslamian; Amirhossein Pirouz; Ehsan Sadeghian

doi:10.18502/crcp.v7i1.9626

Fezzeh Elyasinia Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Nasir Fakhar Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran.
Reza Eslamian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Amirhossein Pirouz Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ehsan Sadeghian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/crcp.v7i1.9626

Keywords: Colitis; Chemotherapy; Ischemia; Irinotecan; 5- Fluorouracil

Abstract

Gastrointestinal complications are common in chemotherapy patients. Although most patients’ abdominal symptoms can be due to mild chemotherapy adverse reactions, severe or life-threatening complications might occur. Typhlitis or neutropenic enterocolitis is a severe bowel wall inflammation in leukemia or solid tumor chemotherapy in neutropenic patients and may contribute to necrosis and colon perforation. Patients undergoing chemotherapy rarely experience colitis that has no standard typhlitis trait. This ischemic colitis-induced chemotherapy had conducted in patients receiving taxane-based agents. Our study presented ischemic colitis in patients receiving 5-fluorouracil, Leucovorin, and Irinotecan for sigmoid cancer that affected the transverse colon alone, unlikely for both typhlitis and chemotherapy-induced ischemic colitis. Given these findings; it is prominent to consider that life-threatening gastrointestinal complications may develop with these agents, and then surgical intervention is needed.