A rare case of pneumatosis intestinalis during adjuvant chemoradiotherapy for oral cancer

Pneumatosis intestinalis (PI) is characterized by the presence of gas in the bowel wall and is associated with a wide range of clinical conditions, such as pulmonary, gastrointestinal, infectious, and autoimmune diseases, and an immunosuppressive state such as that resulting from cancer chemotherapy...

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Bibliographic Details
Published in:Journal of oral and maxillofacial surgery, medicine, and pathology medicine, and pathology, 2021-07, Vol.33 (4), p.438-442
Main Authors: Yamatoji, Masanobu, Shiiba, Masashi, Yamamoto, Junichiro, Takahara, Toshikazu, Takeuchi, Shin, Sawai, Yuki, Kouzu, Yukinao, Miyamoto, Isao, Endo-Sakamoto, Yosuke, Kanazawa, Harusachi, Tanzawa, Hideki
Format: Article
Language:English
Subjects:
Cancer chemotherapy
Cisplatin
Free air
Perforation
Pneumatosis intestinalis
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Summary:Pneumatosis intestinalis (PI) is characterized by the presence of gas in the bowel wall and is associated with a wide range of clinical conditions, such as pulmonary, gastrointestinal, infectious, and autoimmune diseases, and an immunosuppressive state such as that resulting from cancer chemotherapy. It is not a distinct disease but rather a physical or radiographic finding and can be categorized into types: primary and secondary. Primary PI is idiopathic, while secondary PI occurs as a result of an underlying disease. Several theories were suggested for the etiology of this condition. Intestinal gas, mucosal integrity, intraluminal pressure, and bacterial flora play interactive roles in the development of PI; yet, the mechanisms involved remain unclear. PI can be seen in benign or life-threatening situations. Choosing an appropriate treatment owing to the various interpretations of the clinical significance of PI is difficult. An urgent surgical procedure is necessary for patients with signs of bowel perforation, peritonitis, or necrotizing enterocolitis. Potentially, these life-threatening conditions should be ruled out, based on the physical and radiographic findings of the patient. Herein, we report a rare case of PI in a 72-year-old woman who was administrated cisplatin and radiation as adjuvant chemoradiotherapy for oral cancer. During the therapy, free air was detected via chest radiography. Based on the physical and computed tomographic findings, the development of free air was considered as a non-life-threatening PI phenomenon caused by the cancer chemotherapy.
ISSN:2212-5558
2212-5566
DOI:10.1016/j.ajoms.2021.01.013