2021 Volume 54 Issue 3 Pages 228-235
Purpose: Bevacizumab (BV) is a molecularly targeted drug used for several types of cancer, but is known to have specific adverse events. Here, we present cases with acute abdomen during BV administration. Materials and Methods: Between April 2009 and March 2019, 636 patients received BV at our hospital, of whom 13 (2.0%) had acute abdomen. The characteristics and short-term outcomes of these patients were analyzed retrospectively. Results: The patients were 6 males and 7 females, and the median age was 63 years old. The causes of acute abdomen were gastrointestinal perforation (n=10, 77%) (5 colon, 3 duodenum and 2 small intestine), bladder perforation (n=1), ischemic enteritis (n=1) and gallstone attack (n=1). Surgery was performed in 12 patients and conservative treatment was used for one patient with duodenal perforation. Postoperative complications of Clavien-Dindo class ≥IIIa occurred in 6 patients (50%), 8 patients (67%) had surgical site infection and 3 (25%) had wound dehiscence. There were two deaths: the patient who received conservative treatment and the patient with ischemic enteritis. The median postoperative hospital stay was 43 days (4–128 days). Conclusion: In acute abdomen during the course of BV therapy, gastrointestinal perforation was the most frequent cause and the postoperative complication rate was high.
