フルイチ　ヨシヒロ   古市　好宏    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	A case of severe stenosis of hepatic veins and inferior vena cava with stomal variceal bleeding induced by oxaliplatin-based chemotherapy.
掲載誌名	正式名：Clinical journal of gastroenterology 略　 称：Clin J Gastroenterol ISSNコード：18657265/18657265
掲載区分	国外
巻・号・頁	11(2),pp.150-155
著者・共著者	Yamaguchi Hayato, Furuichi Yoshihiro, Kasai Yoshitaka, Takeuchi Hirohito, Yoshimasu Yuu, Sugimoto Katsutoshi, Nakamura Ikuo, Itoi Takao
発行年月	2018/04
概要	A 27-year-old woman with colon cancer and liver metastasis was referred to our hospital. Colectomy and colostomy were performed to improve her ileus. Following 13 sessions of oxaliplatin-based chemotherapy (OC) with mFOLFOX6 + bevacizumab, thrombocytopenia and frequent peristomal bleeding occurred. Computed tomography showed severe ascites, splenomegaly, significant collateral veins around the stoma, and severe stenosis of the hepatic veins (HV) and inferior vena cava (IVC). Ultrasound elastography showed high liver (and spleen) stiffness values. Repeated OC appeared to cause IVC stenosis as a result of worsening sinusoidal obstruction syndrome (SOS), and peristomal variceal bleeding. After ultrasound-guided percutaneous embolization, bleeding did not recur. Unfortunately, the patient died of liver dysfunction caused by severe SOS. The incidence of OC-induced SOS is reported to be about 50%; however, there is apparently no report of OC-induced HV and IVC stenosis, and in most cases, portal hypertension is improved after OC cessation. This is the first report of OC-induced severe HV and IVC stenosis resulting in refractory peristomal variceal bleeding and eventual death.
DOI	10.1007/s12328-017-0814-4
PMID	29318565