Hepatic portal venous gas in a patient undergoing chemotherapy for non-small cell lung cancer

Sakamoto, Akihiro; Matsumoto, Nobuhiro; Arimura, Yasuji; Yanagi, Shigehisa; Iiboshi, Hirotoshi; Tokojima, Masatoshi; Yamashita, Shizuya; Nakazato, Masamitsu

doi:10.1007/s13691-012-0055-9

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…[ 10 ] further describes a patient with non-small cell lung cancer who developed HPVG on a chemotherapy regimen of carboplatin and paclitaxel. He concludes the effects of chemotherapy agents and the increased intraluminal pressure due to severe constipation from opioid analgesics resulted in HPVG [ 10 ]. Thus with our patient, it is plausible that his previous chemotherapy treatment and long-term opioid analgesics could have caused his HPVG.…”

Section: Discussionmentioning

confidence: 99%

A rare occurrence of hepatic portal venous gas in a patient with chemotherapy-induced enterocolitis: the rise of benign aetiologies

Tan

Smith

2015

J. surg. case rep.

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Hepatic portal venous gas (HPVG) is often viewed as an ominous imaging finding with a poor prognosis and a high mortality rate. We recently encountered a case of HPVG in a patient with advanced metastatic prostate cancer previously treated with chemotherapy and radiotherapy. A laparotomy was performed, which was negative. Although HPVG secondary to chemotherapy is extremely rare, we as clinicians need to consider this aetiology and other benign aetiologies. With the increased rate of benign aetiologies and their successful conservative management, the role of emergency laparotomies needs to be re-considered.

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Section: Discussionmentioning

confidence: 99%

A rare occurrence of hepatic portal venous gas in a patient with chemotherapy-induced enterocolitis: the rise of benign aetiologies

Tan

Smith

2015

J. surg. case rep.

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Carboplatin/morphine/paclitaxel

2013

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A 71-year-old man developed hepatic portal venous gas (HPVG) while receiving carboplatin and paclitaxel; constipation due to morphine was also considered to have contributed.The man, who had stage IV non-small cell lung cancer, began receiving zoledronic acid and a time-released formulation of morphine [dosage and route not stated] to treat bone metastases and associated pain. After starting morphine, he developed a side-effect of ileus-like severe constipation [duration of treatment to reaction onset not stated]. He also received chemotherapy consisting of carboplatin and paclitaxel [dosages and routes not stated]. On day 29 of chemotherapy, he developed a slight pain in his upper abdomen and abdominal fullness. He also had symptoms relating to chemotherapy, including nausea, appetite loss and decreased physical activity. Ultrasonography revealed hyperechoic fine particles in the portal vein, and an abdominal CT revealed gas in the peripheral part of his liver. He was diagnosed with HPVG. He had a strong desire to defecate, and after defecation, his abdominal symptoms markedly improved.The man received a nasogastric tube and antibacterials, while oral intake of food or liquid was prohibited. The following day, his abdominal pain almost completely resolved, and subsequent CT and ultrasound imaging revealed complete resolution of gas in the liver. Chemotherapy with carboplatin and paclitaxel was withdrawn, and pemetrexed was started; HPVG did not recur.Author comment: "[W]e speculate that chemotherapy agents, severe constipation caused by the effect of opiate analgesic, and the decreased physical activity (an adverse effect of chemotherapy) worked cooperatively as the causes of HPVG in the present case. Constipation was considered to have played an especially important role in the development of HPVG in our case." Sakamoto A, et al. Hepatic portal venous gas in a patient undergoing chemotherapy for non-small cell lung cancer.

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Hepatic portal venous gas in a patient undergoing chemotherapy for non-small cell lung cancer

Cited by 2 publications

References 8 publications

A rare occurrence of hepatic portal venous gas in a patient with chemotherapy-induced enterocolitis: the rise of benign aetiologies

A rare occurrence of hepatic portal venous gas in a patient with chemotherapy-induced enterocolitis: the rise of benign aetiologies

Carboplatin/morphine/paclitaxel

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