Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Bevacizumab/efeitos adversos , Duodenopatias/induzido quimicamente , Fístula Intestinal/induzido quimicamente , Fístula Vascular/induzido quimicamente , Veias Cavas , Idoso , Carcinoma de Células Escamosas/terapia , Terapia Combinada/métodos , Duodenopatias/diagnóstico por imagem , Feminino , Humanos , Fístula Intestinal/diagnóstico por imagem , Neoplasias do Colo do Útero/terapia , Fístula Vascular/diagnóstico por imagem , Veias Cavas/diagnóstico por imagemRESUMO
An 88-year-old woman on long-term intravitreal bevacizumab presented with acute gastrointestinal hemorrhage. She was stabilized and underwent nonrevealing upper endoscopy. She continued to require intermittent blood transfusions, and resulting computed tomography of the abdomen revealed an aortoduodenal fistula. The patient was undergoing treatment for her macular degeneration with intravitreal bevacizumab, an angiogenesis inhibitor frequently used to treat solid organ malignancies. Systemic administration has been associated with serious adverse events, including gastrointestinal hemorrhage, perforation, and fistula formation. Intravitreal bevacizumab has been used off-label to treat macular degeneration, but data on the safety of this therapy are limited. Given her lack of other risk factors, the authors postulate a potential association between intravitreal bevacizumab and aortoduodenal fistula formation in this patient.