RESUMO
Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.
Assuntos
Dor Abdominal/etiologia , Doenças do Sistema Digestório/complicações , Doenças do Sistema Digestório/diagnóstico , Doença Aguda , Colangite/complicações , Colangite/diagnóstico , Colecistite/complicações , Colecistite/diagnóstico , Doença Crônica , Diagnóstico Diferencial , Doença Diverticular do Colo/complicações , Doença Diverticular do Colo/diagnóstico , Hepatite/complicações , Hepatite/diagnóstico , Humanos , Testes de Função Hepática , Úlcera Péptica Perfurada/complicações , Úlcera Péptica Perfurada/diagnóstico , Exame FísicoRESUMO
Bilateral spontaneous pneumothorax is a rare occurrence in patients with both primary and metastatic lung cancer. Pneumothorax occurring as a complication of vascular endothelial growth factor receptor (VEGFR) inhibitor therapy has not been previously described in the medical literature. Sunitinib malate is a VEGFR inhibitor approved for the treatment of advanced renal cell carcinoma. We present a patient with metastatic renal cell carcinoma manifested as bilateral pulmonary nodules who developed a bilateral spontaneous pneumothorax 3 weeks after initiation of sunitinib therapy. We believe that sunitinib therapy resulted in necrosis of multiple pleural-based pulmonary nodules with central cavernization and ultimately rupture with bronchopleural fistula formation. Based on this experience, we advise that practitioners exercise caution when prescribing anti-VEGFR therapy in patients with pleural-based pulmonary metastases and recognize that the efficacy and toxicity of these agents may be closely linked.
