Volume 84 - 2021 - Fasc.3 - Reviews
Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients: a case series
Pneumatosis Intestinalis (PI) is a rare radiological finding
defined as the presence of extra-luminal gas within the intestinal
wall. Several anti-tumor drugs can induce a damage of the
gastrointestinal walls as an adverse effect, causing loss of mucosal
integrity and endoluminal gas diffusion, responsible for PI
development. We retrospectively analyzed 8 cases of PI detected
through radiological imaging in oncologic patients undergoing
various therapeutic regimens: five patients were receiving
chemotherapy, two molecular targeted therapy (MTT) and one
immunotherapy.
Three patients were asymptomatic and pneumatosis was
incidentally detected at routinary follow-up CT and then treated
conservatively. Five patients presented acute abdomen symptoms
and in these cases bowel perforation was the cause of death. Our
experience confirms PI and perforation as rare complications
of drug toxicity, especially in oncologic patients treated with
combinations of different anticancer drugs and documented the
second reported case of PI associated with atezolizumab and
alectinib single administration.
