2020 Volume 40 Issue 7 Pages 877-880
The patient was a 65–year–old woman with an abdominal tumor who was diagnosed as having metastatic cancer of the cecum with multiple metastases in the liver and lung. She was started on mFOLFOX6＋bevacizumab chemotherapy. Eight months later, abdominal computed tomography (CT) revealed progressive disease and the treatment was switched to FOLFIRI＋bevacizumab. Ten days after the treatment switch, the patient developed right lower abdominal pain. Abdominal CT revealed marked enlargement of the appendix, and emergent surgery was performed under the diagnosis of obstructive appendicitis caused by obstruction of the appendiceal orifice by cecal cancer. Ileocecal resection was performed via a laparoscopic approach and a hand–sutured anastomosis was performed for reconstruction. No postoperative complications were noted. The patient was discharged on postoperative day (POD) 10 and the chemotherapy was resumed on POD 32. Gastrointestinal perforation is a serious complication of bevacizumab therapy, and surgical site infection and dehiscence can cause delayed healing. However, these risks may be decreased by adopting a laparoscopic approach for surgery and a modified method for anastomosis.
