古市 好宏
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Peer reviewed
Title A case of severe stenosis of hepatic veins and inferior vena cava with stomal variceal bleeding induced by oxaliplatin-based chemotherapy.
Journal Formal name:Clinical journal of gastroenterology
Abbreviation:Clin J Gastroenterol
ISSN code:18657265/18657265
Domestic / ForeginForegin
Volume, Issue, Page 11(2),pp.150-155
Author and coauthor Yamaguchi Hayato, Furuichi Yoshihiro, Kasai Yoshitaka, Takeuchi Hirohito, Yoshimasu Yuu, Sugimoto Katsutoshi, Nakamura Ikuo, Itoi Takao
Publication date 2018/04
Summary 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