Abstract
Chemotherapy-induced bowel toxicity is a common problem in patients with cancer. Diarrhea is the most frequent adverse event of several chemotherapy agents. Here, we report a case of a patient with colon cancer who developed multiple small intestinal ulcers after treatment with uracil-tegafur (UFT)/leucovorin (LV). A woman in her 70s underwent a laparoscopic right hemicolectomy for ascending colon cancer. UFT/LV was administered as adjuvant chemotherapy after the operation. She was admitted to our hospital because of severe watery diarrhea 25 days after the administration of UFT/LV. A colonoscopy was performed because a bloody bowel discharge was observed 10 days after hospitalization. Many punched-out ulcers were detected in the ileum. She developed severe abdominal pain 20 days after hospitalization. Intestinal perforation was suspected on abdominal computed tomography, and a subsequent emergency operation was performed. On laparotomy, a perforation with extensive inflammation of the small intestine was detected, and an extensive small intestinal excision, about 70-cm long, and ileostomy were performed. Multiple punched-out ulcers were observed in the resected specimen. Histological findings revealed only nonspecific inflammation. Therefore, it was considered that in our patient, UFT/LV had toxic effects on the small intestine.
