[Case of Hematemesis Cardiopulmonary Arrest after Chemotherapy for Advanced Gastric Cancer].

The case is of a 66-year-old woman who visited a general practitioner with a chief complaint of cough. She was referred to the Internal Medicine Department of our hospital because an abnormal shadow was found in her chest X-ray examination. A CT scan suspected her to have a metastatic lung tumor, and gastric cancer was diagnosed on primary site search. The patient was started on G-SOX therapy. After 2 courses, she experienced massive hematemesis and was referred to the hospital. A CT scan revealed arterial bleeding into the stomach. She went into cardiac arrest shortly afterward, and cardiopulmonary resuscitation was started. Hemostasis was obtained by interventional radiology(IVR). Upper gastrointestinal endoscopy performed after hemostasis showed the tumor to be necrotic and shrunk. Bleeding from advanced gastric cancer is common; however, bleeding due to the effects of chemotherapy have been reported. We report a case of massive bleeding and cardiopulmonary arrest during chemotherapy.

[Central venous access port devices (CVAPD) - related complications in colorectal cancer patients].

OBJECTIVES: Frequency of CVAPD-related complications in colorectal cancer patients is investigated to clarify the relationship to the clinical factors. METHODS: The subjects were 57 patients with unresectable or recurrent colorectal cancer who received interposition operation of CVAPD during the period from February 2006 to April 2009. The clinical factors including the insertion sites, the indwelling period of time, surgical operators, and the types of CVAPD products were analyzed in relation to the complications. RESULTS: The patients were 42 males and 15 females in the median age of 67 (28-82) years at insertion of CVAPD. The reasons for the introduction of CVAPD were liver metastasis in 25 patients, peritoneal metastasis in 12 patients, recurrent lymph node metastasis in 7 patients, lung metastasis in 18 patients, local factors in 8 patients, and other in 4 patients (multiple response). For CVAPD-related troubles, a total of 10 patients (17.5%) postponed the therapeutical treatment; for occurrence of infection in 4 patients (7.0%), thrombosis in 5 (8.8%), and fracture of a catheter in 1 (1.8%). The CV port device was removed in 9 patients. Analytical results showed that the frequency of CV port device-related complications was not affected by the puncture sites, surgical operators, indwelling period of time, and types of CVAPD products. CONCLUSION: Some troubles are often observed which require CVAPD removal, regardless of surgical operators and indwelling period of time, though the frequency of CVAPD-related complications is relatively lower. Review of the operational procedures of the CVAPD insertion and the types of the product to be used, early detection of the complications, and also understanding of the potential risks by the medical staff and patient are important for management of such clinical troubles related to CVAPD.